MEDICARE: DR. CHRISTINA R. GRIFFIN PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	PSY14749	CA

General Provider Information

NPI Number	:	1326269317
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTINA R. GRIFFIN PH.D.

Provider Business Mailing Address
First Line	:	3585 MAPLE ST
Second Line	:	SUITE 235
City	:	VENTURA
State	:	CA
Zip	:	93003-3504
Country	:	US
Telephone Number	:	805-650-0655
Fax Number	:	805-650-0655

Provider Business Practice Location Address
First Line	:	3585 MAPLE ST
Second Line	:	SUITE 235
City	:	VENTURA
State	:	CA
Zip	:	93003-3504
Country	:	US
Telephone Number	:	805-650-0655
Fax Number	:	805-650-0655

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/01/2007
Last Update Date	:	07/08/2007

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