Jared Miller, RADT

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

License

MPSS-QYTVPJ Issued in CA

Practice address

31764 Casino Dr # 200
Lake Elsinore, CA 92530-2312

Phone

(951) 471-4649

Fax

(951) 471-4687

NPI assigned

Aug 30, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Mfi Recovery Center

  • Substance Abuse Rehabilitation Facility
  • Riverside, CA
  • NPI 1881059525
  NPD (past)

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

{
    "created_epoch": "1661817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1205556362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5870 ARLINGTON AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925042037",
            "telephone_number": "951-683-6596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31764 CASINO DR # 200",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925302312",
            "telephone_number": "951-471-4649",
            "fax_number": "951-471-4687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JARED",
        "credential": "RADT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-30",
        "last_updated": "2024-05-13",
        "certification_date": "2023-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "CA",
            "license": "R1476710722",
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "CA",
            "license": "MPSS-QYTVPJ",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daphney Michel
• Karina Michelena
• Michelle Cruz OD Inc
• Midas Recovery LLC
• Gina Michelle Miller, FNP
• Julia Mae Miller, PPS
• Shane Conley Mills
• Lori A Minor-Honore, MFTI
• Antoni A Miranda, CHW
• Crystal Brianne Miranda

• Community Health Worker in Lake Elsinore, CA
• Providers in Lake Elsinore, CA by specialty
• Community Health Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2024; 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.