Provider Demographics
NPI:1215452149
Name:GRIFFITHS, JOE
Entity type:Individual
Prefix:DR
First Name:JOE
Middle Name:
Last Name:GRIFFITHS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3859 18TH ST APT B
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94114-2615
Mailing Address - Country:US
Mailing Address - Phone:509-670-6708
Mailing Address - Fax:
Practice Address - Street 1:402 MONTCLAIRE DR NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87108-1128
Practice Address - Country:US
Practice Address - Phone:509-670-6708
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-11
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
NM426409103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
No101Y00000XBehavioral Health & Social Service ProvidersCounselor