Individual provider Active NPI

Jo Emery Miller, LCSW

  • Clinical Social Worker
  • Pine Valley, CA
National Provider Identifier
1104762558
Registry record updated Apr 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS17267 Issued in CA
Practice address
28928 Deer Creek TRL
Pine Valley, CA 91962-4021
Phone
(619) 933-9703
NPI assigned
Apr 28, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCS17267 CA Primary

Addresses

Primary practice location

28928 Deer Creek TRL
Pine Valley, CA 91962-4021

Mailing address

PO Box 621
28928 Deer Creek Trail
Pine Valley, CA 91962-0621
Phone (619) 933-9703

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LCS17267CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1777334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777334400000",
    "number": "1104762558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 621",
            "address_2": "28928 DEER CREEK TRAIL",
            "city": "PINE VALLEY",
            "state": "CA",
            "postal_code": "919620621",
            "telephone_number": "619-933-9703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28928 DEER CREEK TRL",
            "city": "PINE VALLEY",
            "state": "CA",
            "postal_code": "919624021",
            "telephone_number": "619-933-9703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JO",
        "middle_name": "EMERY",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-04-28",
        "last_updated": "2026-04-28",
        "certification_date": "2026-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS17267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pine Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2026; 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.