Provider Demographics
NPI:1518254002
Name:GRIFFITH, ANNA MARY (OD)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:MARY
Last Name:GRIFFITH
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2565 CEANOTHUS AVE
Mailing Address - Street 2:STE 155
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95973-7615
Mailing Address - Country:US
Mailing Address - Phone:530-400-5490
Mailing Address - Fax:
Practice Address - Street 1:2565 CEANOTHUS AVE
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95973-7615
Practice Address - Country:US
Practice Address - Phone:530-899-3939
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-05
Last Update Date:2017-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14364152W00000X, 152WV0400X, 152WP0200X, 152WS0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
No152WS0006XEye and Vision Services ProvidersOptometristSports Vision