Provider Demographics
NPI:1811199631
Name:GRIFFY, JEFFREY BRYNE (MFT)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:BRYNE
Last Name:GRIFFY
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:MR
Other - First Name:JEFFREY
Other - Middle Name:
Other - Last Name:GRIFFY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MFT
Mailing Address - Street 1:2120 THIBODO CT.
Mailing Address - Street 2:SUITE 230
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92081-7901
Mailing Address - Country:US
Mailing Address - Phone:858-279-1223
Mailing Address - Fax:
Practice Address - Street 1:2120 THIBODO CT.
Practice Address - Street 2:SUITE 230
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92081-7901
Practice Address - Country:US
Practice Address - Phone:858-279-1223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-04
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44394106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist