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NPI Code Detail

MEDICARE: JAELIN GRIFFITHS

MEDICARE: JAELIN GRIFFITHS
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
1104100000XSocial Worker
2171M00000XCase Manager/Care CoordinatorCA
3106S00000XBehavior Technician

General Provider Information

NPI Number : 1629620620
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAELIN GRIFFITHS
Provider Business Mailing Address
First Line : 556 N BILLOW DR
Second Line :
City : SAN DIMAS
State : CA
Zip : 91773-1738
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1717 W MERCED AVE
Second Line :
City : WEST COVINA
State : CA
Zip : 91790-3406
Country : US
Telephone Number : 800-249-1266
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2019
Last Update Date : 01/09/2026

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Directions to “ JAELIN GRIFFITHS ” Practice Location

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