Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | DC22202 | CA |
NPI | 1265852925 |
---|---|
Provider Name | Dr. Angela Griffiths |
First Address | Castro Valley, CA 94546-5915 |
Second Address | Castro Valley, CA 94546-5915 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2014 |
Last Update Date | 21/04/2014 |