1619221447 NPI number — MS. TARINA LYNNETTE GRIFFIN LMFT

Table of content: MS. TARINA LYNNETTE GRIFFIN LMFT (NPI 1619221447)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619221447 NPI number — MS. TARINA LYNNETTE GRIFFIN LMFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GRIFFIN
Provider First Name:
TARINA
Provider Middle Name:
LYNNETTE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LMFT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1619221447
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/31/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6480 WEATHERS PL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN DIEGO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92121-3910
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
858-337-5291
Provider Business Mailing Address Fax Number:
858-999-2294

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6480 WEATHERS PL
Provider Second Line Business Practice Location Address:
SUITE 102
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92121-3910
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-337-5291
Provider Business Practice Location Address Fax Number:
858-999-2294
Provider Enumeration Date:
10/31/2012

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  MFC 51373 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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