Provider Demographics
NPI:1841212990
Name:GRANIT, LORRAINE JOY (PHD)
Entity Type:Individual
Prefix:DR
First Name:LORRAINE
Middle Name:JOY
Last Name:GRANIT
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 1:1181 BOULEVARD WAY
Mailing Address - Street 2:SUITE E
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94595-1186
Mailing Address - Country:US
Mailing Address - Phone:925-945-8008
Mailing Address - Fax:925-945-8008
Practice Address - Street 1:1181 BOULEVARD WAY
Practice Address - Street 2:SUITE E
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94595-1186
Practice Address - Country:US
Practice Address - Phone:925-945-8008
Practice Address - Fax:925-945-8008
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY7713103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist