Provider Demographics
NPI:1992906457
Name:GRIGGS, KIMBERLY (PSYD LMFT)
Entity type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:
Last Name:GRIGGS
Suffix:
Gender:F
Credentials:PSYD LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8192 SANCTUARY DR
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92883-5954
Mailing Address - Country:US
Mailing Address - Phone:909-229-7056
Mailing Address - Fax:
Practice Address - Street 1:8192 SANCTUARY DR
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92883-5954
Practice Address - Country:US
Practice Address - Phone:909-360-1967
Practice Address - Fax:909-751-5546
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA84749101YM0800X, 101YP2500X, 106H00000X
CO84749261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1992906457Medicaid