Provider Demographics
NPI:1205960614
Name:GRIFFIN, LAUREN TOSHIKO
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:TOSHIKO
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 CANDELA CIR
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95835-2094
Mailing Address - Country:US
Mailing Address - Phone:310-985-1141
Mailing Address - Fax:
Practice Address - Street 1:9837 FOLSOM BLVD
Practice Address - Street 2:SUITE F
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95827-1356
Practice Address - Country:US
Practice Address - Phone:916-856-5177
Practice Address - Fax:916-856-5708
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2010-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF50827106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist