MEDICARE: MS. TARINA LYNNETTE GRIFFIN LMFT

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	106H00000X	Marriage & Family Therapist	MFC 51373	CA

General Provider Information

NPI Number	:	1619221447
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TARINA LYNNETTE GRIFFIN LMFT

Provider Business Mailing Address
First Line	:	6480 WEATHERS PL
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92121-3910
Country	:	US
Telephone Number	:	858-337-5291
Fax Number	:	858-999-2294

Provider Business Practice Location Address
First Line	:	6480 WEATHERS PL
Second Line	:	SUITE 102
City	:	SAN DIEGO
State	:	CA
Zip	:	92121-3910
Country	:	US
Telephone Number	:	858-337-5291
Fax Number	:	858-999-2294

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

Provider Enumeration Date	:	10/31/2012
Last Update Date	:	10/31/2012

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