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General NPI Number Information
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NPI Number | 1437174760
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Entity Type | Individual
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Provider Name | MR. MARLIN SHAW GRIFFITH
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Gender | Male
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Dates
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Enumeration Date | 07/13/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1305 FRANKLIN ST SUITE 509
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City | OAKLAND
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State | CA
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Zip | 94612-3213
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Country | US
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Telephone | 510-287-5324
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Fax |
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Provider Business Mailing Address
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Address Line | 1305 FRANKLIN ST SUITE 509
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City | OAKLAND
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State | CA
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Zip | 94612-3213
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY5355
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License Number State | CA
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