Healthcare Provider Details

I. General information

NPI: 1992973010
Provider Name (Legal Business Name): GAYE GRIFFIN RN, MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: GAYE L GRIFFIN RN, MA

II. Dates (important events)

Enumeration Date: 02/11/2008
Last Update Date: 02/07/2020
Certification Date: 02/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5602 VALLEY GLEN WAY
LOS ANGELES CA
90043-2122
US

IV. Provider business mailing address

5602 VALLEY GLEN WAY
LOS ANGELES CA
90043-2122
US

V. Phone/Fax

Practice location:
  • Phone: 310-340-4400
  • Fax: 310-300-1818
Mailing address:
  • Phone: 310-340-4400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License NumberRN508933
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN508933
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN508933
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code163WC1600X
TaxonomyContinuing Education/Staff Development Registered Nurse
License Number7104
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code163WG0600X
TaxonomyGerontology Registered Nurse
License NumberRN508933
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN508933
License Number StateCA
# 7
Primary TaxonomyN
Taxonomy Code163WH1000X
TaxonomyHospice Registered Nurse
License NumberRN508933
License Number StateCA
# 8
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License NumberRN508933
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: