Derek James Millsap, CADC-II

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

A045300817 Issued in CA

Practice address

2001 The Alameda
San Jose, CA 95126-1136

Phone

(408) 261-7777

Fax

(408) 259-2273

NPI assigned

Mar 21, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1521590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521590400000",
    "number": "1205330560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "654 MARY EVELYN DR",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951235519",
            "telephone_number": "408-772-7004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 THE ALAMEDA",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951261136",
            "telephone_number": "408-261-7777",
            "fax_number": "408-259-2273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "438 N White Rd",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951271439",
            "country_code": "US",
            "telephone_number": "408-254-6828",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLSAP",
        "first_name": "DEREK",
        "middle_name": "JAMES",
        "credential": "CADC-II",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-21",
        "last_updated": "2018-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "A045300817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kim Millman, MD PHD
• Kelsey Mills-Bunje
• Carlyn Barbara Mills, DPT
• Richard Doug Mills
• Carly Millsap
• John Milstead
• Catherine Miltenberger
• Thomas B Milus, DC
• Mim Physical Therapy, Inc.
• Cheryl Nanette Mims, LCSW

• Addiction (Substance Use Disorder) Counselor in San Jose, CA
• Providers in San Jose, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2018; 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.