Provider Demographics
NPI:1538115845
Name:GRIFFIN, KATHLEEN ANNA (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:ANNA
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:902 CHELTENHAM
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:00000
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:33 W MISSION ST
Practice Address - Street 2:SUITE 204
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-2455
Practice Address - Country:US
Practice Address - Phone:805-569-7604
Practice Address - Fax:805-569-6509
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2010-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG39286207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA953851088OtherBLUE CROSS OF CALIFORNIA
CA00G392860OtherBLUE SHIELD OF CALIFORNIA
CA00G392860OtherBLUE SHIELD OF CALIFORNIA
CA953851088OtherBLUE CROSS OF CALIFORNIA