Provider Demographics
NPI:1326181660
Name:GRIGGS, KATHLEEN CORAL (NP)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:CORAL
Last Name:GRIGGS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:8519 ROBERTA DR
Mailing Address - Street 2:
Mailing Address - City:EL CERRITO
Mailing Address - State:CA
Mailing Address - Zip Code:94530-2716
Mailing Address - Country:US
Mailing Address - Phone:510-528-1304
Mailing Address - Fax:
Practice Address - Street 1:27200 CALAROGA AVE
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94545-4339
Practice Address - Country:US
Practice Address - Phone:510-264-4109
Practice Address - Fax:510-887-7421
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9525363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal