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General NPI Number Information
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NPI Number | 1639997216
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Entity Type | Individual
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Provider Name | LISA ANN GRIFFIN
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Gender | Female
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Dates
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Enumeration Date | 10/01/2024
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Last Update Date | 10/01/2024
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Provider Practice Location Address
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Address Line | 560 S ST LOUIS ST FL 2
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City | LOS ANGELES
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State | CA
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Zip | 90033-4320
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Country | US
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Telephone | 323-261-4900
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Fax |
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Provider Business Mailing Address
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Address Line | 5023 ROSEMONT AVE
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City | LA CRESCENTA
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State | CA
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Zip | 91214-2128
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Country | US
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Telephone | 917-207-4610
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 149884
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License Number State | CA
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