Provider Demographics
NPI:1548457013
Name:GRIFFO, FRANK (LAC)
Entity type:Individual
Prefix:MR
First Name:FRANK
Middle Name:
Last Name:GRIFFO
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1890 MOUNTAIN VIEW AVE
Mailing Address - Street 2:
Mailing Address - City:PETALUMA
Mailing Address - State:CA
Mailing Address - Zip Code:94952-4859
Mailing Address - Country:US
Mailing Address - Phone:510-847-7417
Mailing Address - Fax:
Practice Address - Street 1:267 ARLINGTON AVE
Practice Address - Street 2:SUITE D
Practice Address - City:KENSINGTON
Practice Address - State:CA
Practice Address - Zip Code:94707-1400
Practice Address - Country:US
Practice Address - Phone:510-528-0132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-28
Last Update Date:2019-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10790171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist