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General NPI Number Information
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NPI Number | 1598257453
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Entity Type | Individual
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Provider Name | CHARLES GRIFFITH
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Gender | Male
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Dates
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Enumeration Date | 06/05/2018
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Last Update Date | 11/06/2024
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Provider Practice Location Address
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Address Line | 69300 30TH AVE
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City | CATHEDRAL CITY
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State | CA
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Zip | 92234-4921
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Country | US
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Telephone | 951-765-7702
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Fax |
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Provider Business Mailing Address
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Address Line | 3255 E TAHQUITZ CANYON WAY
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City | PALM SPRINGS
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State | CA
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Zip | 92262-6958
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 101YS0200X
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Taxonomy Name | School Counselor
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License Number | 230235025
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License Number State | CA
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