Individual provider Active NPI

Marianne M Miller, PHD, LMFT

  • Marriage & Family Therapist
  • San Diego, CA
National Provider Identifier
1235585696
Registry record updated May 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
87667 Issued in CA
Practice address
10455 Pomerado Rd
Daley Hall, Room 206D
San Diego, CA 92131-1717
Phone
(858) 699-3754
NPI assigned
May 4, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 87667 CA Primary
Marriage & Family Therapist 106H00000X 5209 TX

Addresses

Primary practice location

10455 Pomerado Rd
Daley Hall, Room 206D
San Diego, CA 92131-1717

Mailing address

9921 Carmel Mountain Rd
Unit 374
San Diego, CA 92129-2813
Phone (858) 699-3754

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Dec 2, 2024 through Dec 2, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
5209TXMDMarriage & Family Therapist
87667CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1462320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462320000000",
    "number": "1235585696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9921 CARMEL MOUNTAIN RD",
            "address_2": "UNIT 374",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921292813",
            "telephone_number": "858-699-3754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10455 POMERADO RD",
            "address_2": "DALEY HALL, ROOM 206D",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921311717",
            "telephone_number": "858-699-3754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "MARIANNE",
        "middle_name": "M",
        "credential": "PHD, LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-04",
        "last_updated": "2016-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "87667",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "5209",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.