Provider Demographics
NPI:1740229244
Name:GRANDINETTI, CORINNE C C (MFT)
Entity Type:Individual
Prefix:MRS
First Name:CORINNE
Middle Name:C C
Last Name:GRANDINETTI
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:CORINNE
Other - Middle Name:C
Other - Last Name:CAIKINS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 609001
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92160-9001
Mailing Address - Country:US
Mailing Address - Phone:619-528-4600
Mailing Address - Fax:619-528-4625
Practice Address - Street 1:277 RANCHEROS DR
Practice Address - Street 2:SUITE 301
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92069-2976
Practice Address - Country:US
Practice Address - Phone:760-471-4073
Practice Address - Fax:760-471-4078
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC25376106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist