Provider Demographics
NPI:1780355818
Name:GRIFFITH, ADRIENNE DENISE (LCSW)
Entity type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:DENISE
Last Name:GRIFFITH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6030 SANTO RD STE 1
Mailing Address - Street 2:BOX 420525
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92142
Mailing Address - Country:US
Mailing Address - Phone:619-005-4832
Mailing Address - Fax:
Practice Address - Street 1:5175 ABUELA DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92124-2020
Practice Address - Country:US
Practice Address - Phone:619-208-7636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-28
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1021541041C0700X
IL149.0237271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical