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Individual

GLENN GRIFFIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1600 CAMPUS RD, LOS ANGELES, CA 90041-3314
(323) 259-2799
Mailing address
1600 CAMPUS RD, LOS ANGELES, CA 90041-3314
(626) 497-4134

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY12813
CA
103TF0200X
Forensic Psychologist
PSY12813
CA

Other

Enumeration date
10/12/2012
Last updated
10/13/2023
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