Healthcare Provider Details

I. General information

NPI: 1316812480
Provider Name (Legal Business Name): GRIFFIN MICAH FINCHUM ACSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2025
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 EMBARCADERO STE 303
OAKLAND CA
94606-5227
US

IV. Provider business mailing address

1420 TURK ST PH 1E
SAN FRANCISCO CA
94115-4791
US

V. Phone/Fax

Practice location:
  • Phone: 209-647-6200
  • Fax: 209-647-6210
Mailing address:
  • Phone: 317-599-0908
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberASW133151
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: