Provider Demographics
NPI:1629875935
Name:GRIFFIN, ELANA LIBBY
Entity type:Individual
Prefix:
First Name:ELANA
Middle Name:LIBBY
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:728 4TH ST # AF
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95501-0506
Mailing Address - Country:US
Mailing Address - Phone:707-572-9275
Mailing Address - Fax:
Practice Address - Street 1:2460 SONNENFELT RD
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:CA
Practice Address - Zip Code:95524-9308
Practice Address - Country:US
Practice Address - Phone:707-572-9257
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-26
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA014840374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula