Healthcare Provider Details

I. General information

NPI: 1215368584
Provider Name (Legal Business Name): MELANIE ANN SWEENEY GRIFFITH I MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MELANIE ANN SWEENEYGRIFFITH MA

II. Dates (important events)

Enumeration Date: 12/11/2013
Last Update Date: 12/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2325 CLEMENT AVE
ALAMEDA CA
94501-7063
US

IV. Provider business mailing address

6453 WESTOVER DR
OAKLAND CA
94611-1605
US

V. Phone/Fax

Practice location:
  • Phone: 510-629-6326
  • Fax: 510-865-1930
Mailing address:
  • Phone: 510-629-6326
  • Fax: 510-865-1930

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: