Provider Demographics
NPI:1528313582
Name:GRIFFITH, KATRINA ELENA (DPT)
Entity type:Individual
Prefix:
First Name:KATRINA
Middle Name:ELENA
Last Name:GRIFFITH
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1446 14TH AVE
Mailing Address - Street 2:A
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94122-3506
Mailing Address - Country:US
Mailing Address - Phone:857-205-4427
Mailing Address - Fax:
Practice Address - Street 1:1446 14TH AVE
Practice Address - Street 2:A
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94122-3506
Practice Address - Country:US
Practice Address - Phone:857-205-4427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-16
Last Update Date:2012-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT36773225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist