Healthcare Provider Details

I. General information

NPI: 1285173864
Provider Name (Legal Business Name): PRECIOUS GRIFFITHS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/16/2017
Last Update Date: 02/16/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5150 GAYNOR AVE
ENCINO CA
91436-1441
US

IV. Provider business mailing address

5150 GAYNOR AVE
ENCINO CA
91436-1441
US

V. Phone/Fax

Practice location:
  • Phone: 818-941-5088
  • Fax:
Mailing address:
  • Phone: 818-941-5088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number422026
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number422026
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number422026
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License Number422026
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code163WN0003X
TaxonomyLow-Risk Neonatal Registered Nurse
License Number422026
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number422026
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: