Provider Demographics
NPI:1548464571
Name:FERRIS, ELIZABETH GRIFFIN (RD)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:GRIFFIN
Last Name:FERRIS
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1781 20TH AVE
Mailing Address - Street 2:
Mailing Address - City:KINGSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:93631-2022
Mailing Address - Country:US
Mailing Address - Phone:559-897-4852
Mailing Address - Fax:
Practice Address - Street 1:CLOVIS COMMUNITY MEDICAL CENTER
Practice Address - Street 2:2755 HERNDON AVENUE
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611
Practice Address - Country:US
Practice Address - Phone:559-324-4000
Practice Address - Fax:559-324-3732
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
916376133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered