Provider Demographics
NPI:1548074263
Name:GRIFFITH, BIANCA NAOMI
Entity type:Individual
Prefix:MISS
First Name:BIANCA
Middle Name:NAOMI
Last Name:GRIFFITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2352 WOODHILL DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:94565-7332
Mailing Address - Country:US
Mailing Address - Phone:925-628-6841
Mailing Address - Fax:
Practice Address - Street 1:5668 BAY ST STE 214
Practice Address - Street 2:
Practice Address - City:EMERYVILLE
Practice Address - State:CA
Practice Address - Zip Code:94608-2408
Practice Address - Country:US
Practice Address - Phone:707-641-4615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-04
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAL9961174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist