Provider Demographics
NPI:1386854099
Name:GRIFFIN, DOROTHY (PHD)
Entity Type:Individual
Prefix:DR
First Name:DOROTHY
Middle Name:
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 FAIRMONT DRIVE
Mailing Address - Street 2:GUIDANCE CLINIC
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94578
Mailing Address - Country:US
Mailing Address - Phone:510-667-3010
Mailing Address - Fax:510-667-3010
Practice Address - Street 1:2500 FAIRMONT DR
Practice Address - Street 2:GUIDANCE CLINIC
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94578-1006
Practice Address - Country:US
Practice Address - Phone:510-667-3010
Practice Address - Fax:510-667-3010
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY9265103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical