Provider Demographics
NPI:1619221447
Name:GRIFFIN, TARINA LYNNETTE (LMFT)
Entity Type:Individual
Prefix:MS
First Name:TARINA
Middle Name:LYNNETTE
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6480 WEATHERS PL
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-3910
Mailing Address - Country:US
Mailing Address - Phone:858-337-5291
Mailing Address - Fax:858-999-2294
Practice Address - Street 1:6480 WEATHERS PL
Practice Address - Street 2:SUITE 102
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-3910
Practice Address - Country:US
Practice Address - Phone:858-337-5291
Practice Address - Fax:858-999-2294
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-31
Last Update Date:2012-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 51373106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist