Provider Demographics
NPI:1588901342
Name:GREIF, ANDREW DAVID (MA)
Entity type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:DAVID
Last Name:GREIF
Suffix:
Gender:M
Credentials:MA
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 3172
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-0172
Mailing Address - Country:US
Mailing Address - Phone:818-848-1488
Mailing Address - Fax:
Practice Address - Street 1:4444 W RIVERSIDE DR STE 208
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4048
Practice Address - Country:US
Practice Address - Phone:818-848-1488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-13
Last Update Date:2013-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC42217106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist