Active NPI
Debra Miller, PSY.D.
- Psychologist
- Auburn, CA
National Provider Identifier
1184984601
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY24988
- Practice address
- 1121 Maidu Dr
Auburn, CA 95603-5808 - Phone
- (530) 888-1118
- NPI assigned
- May 17, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY24988 | CA | Primary |
Addresses
Primary practice location
1121 Maidu Dr
Auburn, CA 95603-5808
Mailing address
PO Box 758
Cedar Ridge, CA 95924-0758
Phone (530) 477-1976
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150716001465 | CA | Practitioner - Psychologist Billing Independently | 8628226883 | Practice locations: Nevada City, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2003
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
825 Zion St
Nevada City, CA 95959-2922
Phone (530) 210-0047
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24988 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1337212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1337212800000",
"number": "1184984601",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 758",
"city": "CEDAR RIDGE",
"state": "CA",
"postal_code": "959240758",
"telephone_number": "530-477-1976"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1121 MAIDU DR",
"city": "AUBURN",
"state": "CA",
"postal_code": "956035808",
"telephone_number": "530-888-1118"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "DEBRA",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-05-17",
"last_updated": "2012-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY24988",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Auburn, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.