Provider Demographics
NPI:1427264845
Name:GRIFFIN, MICHELLE LOUISE (AUD)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:LOUISE
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:DR
Other - First Name:MICHELLE
Other - Middle Name:LOUISE
Other - Last Name:MCGRATH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:12791 NEWPORT AVE
Mailing Address - Street 2:101
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-2751
Mailing Address - Country:US
Mailing Address - Phone:714-731-6549
Mailing Address - Fax:714-730-5372
Practice Address - Street 1:450 SUTTER ST RM 1400
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94108-4003
Practice Address - Country:US
Practice Address - Phone:415-362-2901
Practice Address - Fax:415-839-6677
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2019-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA7075231HA2400X, 231HA2500X, 237600000X
CAAU3119231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Practitioner
No231HA2500XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Supplier
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter