Provider Demographics
NPI:1407158975
Name:GROFIK, ELAINE K (PHD)
Entity type:Individual
Prefix:
First Name:ELAINE
Middle Name:K
Last Name:GROFIK
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:PO BOX 262010
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92196-2010
Mailing Address - Country:US
Mailing Address - Phone:619-518-2869
Mailing Address - Fax:858-216-5625
Practice Address - Street 1:530 LOMAS SANTA FE DR
Practice Address - Street 2:SUITE M
Practice Address - City:SOLANA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92075-1349
Practice Address - Country:US
Practice Address - Phone:877-274-5053
Practice Address - Fax:858-216-5625
Is Sole Proprietor?:No
Enumeration Date:2010-12-03
Last Update Date:2010-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23478103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist