Healthcare Provider Details

I. General information

NPI: 1407785264
Provider Name (Legal Business Name): KELSEY M. GRIFFITH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13743 VENTURA BLVD STE 350
SHERMAN OAKS CA
91423-5598
US

IV. Provider business mailing address

PO BOX 27645
LOS ANGELES CA
90027-0645
US

V. Phone/Fax

Practice location:
  • Phone: 858-333-6856
  • Fax:
Mailing address:
  • Phone: 818-633-4527
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number160427
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: