Healthcare Provider Details

I. General information

NPI: 1992551410
Provider Name (Legal Business Name): ALEXANDRA GRIFFIN M.A., APCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/25/2024
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4231 BALBOA AVE # 1341
SAN DIEGO CA
92117-5504
US

IV. Provider business mailing address

4231 BALBOA AVE # 1341
SAN DIEGO CA
92117-5504
US

V. Phone/Fax

Practice location:
  • Phone: 619-663-8407
  • Fax:
Mailing address:
  • Phone: 619-663-8407
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number22901
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: