Provider Demographics
NPI:1437041753
Name:GRIFFITH, ALICIA MICHELE (MPT)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:MICHELE
Last Name:GRIFFITH
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:MICHELE
Other - Last Name:WORTMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:161 WESTCHESTER ST
Mailing Address - Street 2:
Mailing Address - City:MORAGA
Mailing Address - State:CA
Mailing Address - Zip Code:94556-1754
Mailing Address - Country:US
Mailing Address - Phone:415-533-7087
Mailing Address - Fax:
Practice Address - Street 1:161 WESTCHESTER ST
Practice Address - Street 2:
Practice Address - City:MORAGA
Practice Address - State:CA
Practice Address - Zip Code:94556-1754
Practice Address - Country:US
Practice Address - Phone:415-533-7087
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-21
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171400000X
CA26514225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No171400000XOther Service ProvidersHealth & Wellness Coach