Provider Demographics
NPI:1215950456
Name:GRIFFIN, JOAN MARIE (MFT)
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:MARIE
Last Name:GRIFFIN
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 1:3821 SHAKESPEARE DR
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93033-6868
Mailing Address - Country:US
Mailing Address - Phone:805-488-3954
Mailing Address - Fax:
Practice Address - Street 1:500 E ESPLANADE DR
Practice Address - Street 2:SUITE 860
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-2110
Practice Address - Country:US
Practice Address - Phone:805-981-0221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC25524101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health