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NPI Code Detail

MEDICARE: JONASTASYA GRIFFITH

MEDICARE: JONASTASYA GRIFFITH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training ProgramCA

General Provider Information

NPI Number : 1679361174
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONASTASYA GRIFFITH
Provider Business Mailing Address
First Line : 921 PONDEROSA AVE APT 72
Second Line :
City : SUNNYVALE
State : CA
Zip : 94086-8900
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 800 W EL CAMINO REAL STE 180
Second Line :
City : MOUNTAIN VIEW
State : CA
Zip : 94040-2586
Country : US
Telephone Number : 949-743-1457
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2025
Last Update Date : 04/25/2025

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Directions to “ JONASTASYA GRIFFITH ” Practice Location

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