Basic Information
| Provider Information | |||||||||
| NPI: | 1720286768 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GRIFFIN | ||||||||
| FirstName: | WINNIFRED | ||||||||
| MiddleName: | V | ||||||||
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| Credential: | PHYSCIAN ASST. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1100 DELBON AVE | ||||||||
| Address2: | |||||||||
| City: | TURLOCK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 953822021 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2096670905 | ||||||||
| FaxNumber: | 2096670974 | ||||||||
| Practice Location | |||||||||
| Address1: | 1100 DELBON AVE | ||||||||
| Address2: | |||||||||
| City: | TURLOCK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 953822021 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2096670905 | ||||||||
| FaxNumber: | 2096670974 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/10/2007 | ||||||||
| LastUpdateDate: | 07/10/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | 11601 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.