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770 11th St Ste B Arcata CA 95521-5838 | |
| (707) 267-7931 | |
| (707) 306-7253 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 770 11th St Ste B, Arcata, California |
| Authorized Official Name and Position | Carol Elizabeth Griffin (OWNER, MEDICAL DIRECTOR) |
| Authorized Official Contact | 7072677931 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
770 11th St Ste B Arcata CA 95521-5838 Ph: (707) 267-7931 | 770 11th St Ste B Arcata CA 95521-5838 Ph: (707) 267-7931 |
| NPI Number | 1891556585 |
|---|---|
| Provider Enumeration Date | 01/19/2024 |
| Last Update Date | 10/29/2024 |
| Certification Date | 10/24/2024 |
| Medicare PECOS PAC ID | 4284075177 |
|---|---|
| Medicare Enrollment ID | O20240509000855 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891556585 | NPI | - | NPPES |
| Provider Name | Michael D Fratkin |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1508892738 PECOS PAC ID: 7113981523 Enrollment ID: I20041116000465 |
| Provider Name | Carol E Griffin |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1912269408 PECOS PAC ID: 0345499901 Enrollment ID: I20180621002739 |
| Provider Name | Melissa Kate Sandeen |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1376680611 PECOS PAC ID: 4082056692 Enrollment ID: I20240529000838 |
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