Provider Demographics
NPI:1891931903
Name:GIFFROW, HELEN (MFT)
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:
Last Name:GIFFROW
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5392
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95062
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:501 MISSION ST
Practice Address - Street 2:STE. 103
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060-3661
Practice Address - Country:US
Practice Address - Phone:708-680-7108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-18
Last Update Date:2015-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABWASOCFSPOtherMEDI-CAL
CA41BWOtherMEDI-CAL
CAN4342999OtherDRIVER'S LICENSE
CAPRVNBROtherMEDI-CAL