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General NPI Number Information
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NPI Number | 1548074263
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Entity Type | Individual
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Provider Name | MISS BIANCA NAOMI GRIFFITH
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Gender | Female
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Dates
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Enumeration Date | 02/04/2025
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Last Update Date | 02/04/2025
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Provider Practice Location Address
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Address Line | 5668 BAY ST STE 214
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City | EMERYVILLE
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State | CA
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Zip | 94608-2408
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Country | US
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Telephone | 707-641-4615
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Fax |
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Provider Business Mailing Address
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Address Line | 2352 WOODHILL DR
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City | PITTSBURG
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State | CA
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Zip | 94565-7332
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Country | US
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Telephone | 925-628-6841
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | L9961
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License Number State | CA
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