Raechal Brooks McMillan, AU.D

Primary specialty

AudiologistTaxonomy code 231H00000X

Practice address

710 S Broadway Ste 220
Walnut Creek, CA 94596-5234

Phone

(925) 295-6933

NPI assigned

Aug 23, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1629676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640649600000",
    "number": "1013684646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "835 ARLINGTON CT",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895093200",
            "telephone_number": "775-229-5435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 S BROADWAY STE 220",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945965234",
            "telephone_number": "925-295-6933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMILLAN",
        "first_name": "RAECHAL",
        "middle_name": "BROOKS",
        "credential": "AU.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-23",
        "last_updated": "2021-12-28",
        "certification_date": "2021-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "710 S Broadway",
            "city": "Walnut Creek",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945965294",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Erin McKnew, PSY.D.
• Dion Robert McLennan
• Thomas McMahan
• Carol Jean McMenamy, LCSW
• Brim Aaron McMillan-Gordon, DPM
• Damion McMiller
• Kai Jada McMillian
• Tyson John McMullen, PA-C
• Shantelle Lynette McNabb
• Kristina Kelley McNaught, PA-C

• Audiologist in Walnut Creek, CA
• Providers in Walnut Creek, CA by specialty
• Audiologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.