Provider Demographics
NPI:1376893206
Name:GRISAFFI, BRITTNEY ANN
Entity Type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:ANN
Last Name:GRISAFFI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BRITTNEY
Other - Middle Name:ANN
Other - Last Name:NATALO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 4105
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92628-4105
Mailing Address - Country:US
Mailing Address - Phone:714-797-6242
Mailing Address - Fax:
Practice Address - Street 1:188 E 17TH ST STE 201
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92627
Practice Address - Country:US
Practice Address - Phone:714-797-6242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-18
Last Update Date:2019-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist