Kristin Grannis, MFTI 73996

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

112747 Issued in CA

Practice address

5158 Clareton Dr Unit 1058
Agoura Hills, CA 91376-7056

Phone

(310) 929-0935

NPI assigned

Nov 30, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1448841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701648000000",
    "number": "1619341773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1058",
            "city": "AGOURA HILLS",
            "state": "CA",
            "postal_code": "913761058",
            "telephone_number": "310-929-0935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5158 CLARETON DR UNIT 1058",
            "city": "AGOURA HILLS",
            "state": "CA",
            "postal_code": "913767056",
            "telephone_number": "310-929-0935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANNIS",
        "first_name": "KRISTIN",
        "credential": "MFTI 73996",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-30",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "112747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lillian Janine Goldfarb, LCSW
• Sarah Goldstein, DMD
• Affider E Gonzalez de Bermudez
• Tracy Fabrick Gottbetter, M.A.
• Graceful Aging Hospice Care, Inc.
• Tracy T Grant, PPS
• W. Christopher Grant, PHD
• Richard Gregory, MPSA, PA-C
• Becky Lynn Grenfell, LPCC
• Cheryl Robin Grenville, M.S.

• Marriage & Family Therapist in Agoura Hills, CA
• Providers in Agoura Hills, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2023; 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.