Healthcare Provider Details

I. General information

NPI: 1043050495
Provider Name (Legal Business Name): ALISHA R MCGRIFF NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2024
Last Update Date: 03/05/2025
Certification Date: 03/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HOSPITAL DR
VALLEJO CA
94589-2580
US

IV. Provider business mailing address

PO BOX 255228
SACRAMENTO CA
95865-5228
US

V. Phone/Fax

Practice location:
  • Phone: 707-427-4900
  • Fax:
Mailing address:
  • Phone: 916-854-6769
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95030257
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: