Individual provider Active NPI

Susan Kay Miller, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Santa Clara, CA
National Provider Identifier
1134560691
Registry record updated Jul 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
23120 Issued in CA
Practice address
5201 Great America Pkwy Ste 320
Santa Clara, CA 95054-1140
Phone
(323) 205-7088
NPI assigned
Jul 12, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 23120 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 23120 CA Primary

Addresses

Primary practice location

5201 Great America Pkwy Ste 320
Santa Clara, CA 95054-1140

Mailing address

1431 Santa Cruz
Longview, TX 75601-8629
Phone (360) 918-1154

Other names 1

  • Susan Kay McCullah Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20161215001575 CA Practitioner - Nurse Practitioner 9032439559 Reassigns benefits to 2 organizations
I20220207000648 TX Practitioner - Nurse Practitioner 9032439559 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ehab Yacoub MD IncGroup PAC ID 5092099523, 179 clinicians

Practice addresses (Care Compare)

1225 W 190TH St
Suite 280
Gardena, CA 90248-4305
Phone (877) 515-8113

Hospital & facility affiliations

  • St Elizabeth Community Hospital Hospital, Red Bluff, CA, CCN 050042
  • Fairchild Medical Center Hospital, Yreka, CA, CCN 051316

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
23120CAMDClinical Psychologist
686846CAMDLicensed Vocational Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Pih Health Physicians CurrentSince Nov 5, 2016 Accepting new patients
Psychiatry of Texas PLLC Family CurrentSince May 30, 2024 Accepting new patients
North Texas Physician Services, PLLC Nurse Practitioner CurrentSince Aug 6, 2024 Accepting new patients
Ehab Yacoub MD Inc. CurrentSince Jul 17, 2025 Accepting new patients
Southern Physician Group Management LLC CurrentSince Jul 1, 2022 Accepting new patients
Pih Health Physicians CurrentSince Nov 5, 2016 Accepting new patients
Pih Health Physicians Current Accepting new patients
Dignity Health Past Accepting new patients

Locations

1225 W 190th St
Ste 280
Gardena, CA 90248
Phone (310) 515-8113

12675 La Mirada Blvd
Ste 201401
La Mirada, CA 90638
Phone (562) 903-7339

17075 Devonshire St
Ste 204
Northridge, CA 91325
Phone (818) 368-8929

6203 San Ignacio Ave
Ste 110
San Jose, CA 95119
Phone (408) 638-9569

15733 Whittier Blvd
Whittier, CA 90603
Phone (562) 947-7754

3333 N Foster Maldonado Blvd
Eagle Pass, TX 78852
Phone (830) 733-5321

7877 Willow Chase Blvd
Houston, TX 77070
Phone 8328694818109

700 E Marshall Ave
Longview, TX 75601
Phone (903) 236-2000

2600 Saint Michael Dr
Texarkana, TX 75503
Phone (903) 614-1000

Organizations & group practices 8

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1373587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751414400000",
    "number": "1134560691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1431 SANTA CRUZ",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756018629",
            "telephone_number": "360-918-1154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 GREAT AMERICA PKWY STE 320",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950541140",
            "telephone_number": "323-205-7088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "SUSAN",
        "middle_name": "KAY",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-12",
        "last_updated": "2025-07-02",
        "certification_date": "2025-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "23120",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "23120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "MCCULLAH",
            "middle_name": "KAY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Santa Clara, CA

Sources for this page

Verify at the official NPI Registry.