Healthcare Provider Details

I. General information

NPI: 1811608235
Provider Name (Legal Business Name): JOSHUA TODD GRIFFITH V AMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2022
Last Update Date: 01/24/2025
Certification Date: 01/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1020 MCCOURTNEY RD
GRASS VALLEY CA
95949-7453
US

IV. Provider business mailing address

1020 MCCOURTNEY RD
GRASS VALLEY CA
95949-7453
US

V. Phone/Fax

Practice location:
  • Phone: 530-478-0900
  • Fax:
Mailing address:
  • Phone: 916-926-3318
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT148992
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberAMFT148992
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: