Provider Demographics
NPI:1043599012
Name:GRIGORIEVA, ASYA (PHD)
Entity type:Individual
Prefix:DR
First Name:ASYA
Middle Name:
Last Name:GRIGORIEVA
Suffix:
Gender:F
Credentials:PHD
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 590293
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94159-0293
Mailing Address - Country:US
Mailing Address - Phone:415-629-8909
Mailing Address - Fax:
Practice Address - Street 1:3245 GEARY BLVD
Practice Address - Street 2:#590293
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-9411
Practice Address - Country:US
Practice Address - Phone:415-629-8909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-09
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY29111103TC0700X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical