Individual provider Active NPI

Caroline Frances Miner, M.D.

  • Child & Adolescent Psychiatry Physician
  • Santa Cruz, CA
National Provider Identifier
1124132790
Registry record updated Apr 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
G143127 Issued in CA
Practice address
2025 Soquel Ave
Santa Cruz, CA 95062-1323
Phone
(831) 423-4111
NPI assigned
Aug 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X G143127 CA Primary

Addresses

Primary practice location

2025 Soquel Ave
Santa Cruz, CA 95062-1323

Mailing address

325 Distel Cir
Los Altos, CA 94022-1408
Phone (831) 423-4111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161017001943 CA Practitioner - Psychiatry 5890829170 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
New York University School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

2025 Soquel Ave
Santa Cruez, CA 95062-1323
Phone (831) 423-4111

550 S Green Valley Rd
Watsonville, CA 95076-3053
Phone (831) 458-5865

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G143127CAMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Bay Medical Foundation CurrentSince Oct 1, 2016 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Oct 1, 2016 Accepting new patients
Catalina Foothills Pediatric Psychiatry Past Accepting new patients
Inner Journey Psychological Services, LLC PastSince Oct 26, 2005 Accepting new patients

Locations

3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800

370 Distel Cir
Los Altos, CA 94022
Phone (650) 254-5200

325 Distel Cir
Los Altos, CA 94022
Phone (510) 204-3977

2350 W El Camino Real
Fl 2
Mountain View, CA 94040
Phone (650) 691-6174

795 El Camino Real
#1112
Palo Alto, CA 94301

795 El Camino Real
Palo Alto, CA 94301
Phone (650) 324-1832

123 S San Mateo Dr
San Mateo, CA 94401
Phone (650) 343-4200

2025 Soquel Ave
Santa Cruz, CA 95062
Phone (408) 423-4111

2200 Soquel Ave
Santa Cruz, CA 95062
Phone (831) 460-7388

550 S Green Valley Rd
Watsonville, CA 95076
Phone (831) 458-5865

Interoperability endpoints

  • Direct secure messaging: cminer348251@hisp.ehr.sutterhealth.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586217600000",
    "number": "1124132790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 DISTEL CIR",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221408",
            "telephone_number": "831-423-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 SOQUEL AVE",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950621323",
            "telephone_number": "831-423-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINER",
        "first_name": "CAROLINE",
        "middle_name": "FRANCES",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-19",
        "last_updated": "2020-04-07",
        "certification_date": "2020-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "G143127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Cruz, CA

Sources for this page

Verify at the official NPI Registry.