Individual provider Active NPI

Jeffrey E. Miller, PH.D.

  • Clinical Psychologist
  • Sacramento, CA
National Provider Identifier
1174750657
Registry record updated Jun 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY4795 Issued in CA
Practice address
3353 Bradshaw Road
Suite 211
Sacramento, CA 95827-2610
Phone
(916) 366-9260
Fax
(916) 366-9265
NPI assigned
Jun 11, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY4795 CA Primary

Addresses

Primary practice location

3353 Bradshaw Road
Suite 211
Sacramento, CA 95827-2610

Mailing address

3353 Bradshaw Road
Suite 211
Sacramento, CA 95827-2610
Phone (916) 366-9260

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY4795CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1244678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244678400000",
    "number": "1174750657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3353 BRADSHAW ROAD",
            "address_2": "SUITE 211",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958272610",
            "telephone_number": "916-366-9260",
            "fax_number": "916-366-9265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3353 BRADSHAW ROAD",
            "address_2": "SUITE 211",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958272610",
            "telephone_number": "916-366-9260",
            "fax_number": "916-366-9265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JEFFREY",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-11",
        "last_updated": "2009-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY4795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2009; 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.