Active NPI
Marianne M Miller, PHD, LMFT
- Marriage & Family Therapist
- San Diego, CA
National Provider Identifier
1235585696
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 87667
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 5209 | TX | MD | Marriage & Family Therapist |
| 87667 | CA | MD | Pharmacist |
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.