Provider Demographics
NPI:1760775597
Name:GRIFFIN, MAUREEN LORRAINE (ACUPUNCTURIST)
Entity Type:Individual
Prefix:MS
First Name:MAUREEN
Middle Name:LORRAINE
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:ACUPUNCTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:383 PALOMAR CT
Mailing Address - Street 2:
Mailing Address - City:SAN BRUNO
Mailing Address - State:CA
Mailing Address - Zip Code:94066-4711
Mailing Address - Country:US
Mailing Address - Phone:650-871-0771
Mailing Address - Fax:
Practice Address - Street 1:383 PALOMAR CT
Practice Address - Street 2:
Practice Address - City:SAN BRUNO
Practice Address - State:CA
Practice Address - Zip Code:94066-4711
Practice Address - Country:US
Practice Address - Phone:650-871-0771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-26
Last Update Date:2011-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA252043163W00000X, 163WH0200X
CAAC 3814171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No163W00000XNursing Service ProvidersRegistered Nurse
No163WH0200XNursing Service ProvidersRegistered NurseHome Health