Individual provider Active NPI

Lajean Griffin, PSYCHOLOGIST

  • Clinical Psychologist
  • Covina, CA
National Provider Identifier
1417091091
Registry record updated Apr 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY22618 Issued in CA
Practice address
1175 E Garvey St Ste 100
Covina, CA 91724-3677
Phone
(626) 967-6421
Fax
(626) 967-9670
NPI assigned
Feb 16, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY22618 CA Primary

Addresses

Primary practice location

1175 E Garvey St Ste 100
Covina, CA 91724-3677

Mailing address

PO Box 4085
Covina, CA 91723-0485
Phone (626) 391-4011

Other names 1

  • Lajean Griffin Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY22618CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Clinics Past Accepting new patients
Pacific Clinics Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333411200000",
    "number": "1417091091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4085",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917230485",
            "telephone_number": "626-391-4011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 E GARVEY ST STE 100",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917243677",
            "telephone_number": "626-967-6421",
            "fax_number": "626-967-9670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIFFIN",
        "first_name": "LAJEAN",
        "name_prefix": "Dr.",
        "credential": "PSYCHOLOGIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-16",
        "last_updated": "2012-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY22618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAJEAN",
            "last_name": "GRIFFIN",
            "credential": "LMFT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Covina, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.