Individual provider Active NPI

Michael A Miller, CADC

  • Adult Companion
  • Modesto, CA
National Provider Identifier
1295150837
Registry record updated May 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult CompanionTaxonomy code 372600000X
License
C10261214 Issued in CA
Practice address
800 Scenic Dr
Modesto, CA 95350-6131
Phone
(209) 525-6150
NPI assigned
Feb 19, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Addiction (Substance Use Disorder) Counselor 101YA0400X C10261214 CA
Peer Specialist 175T00000X MPSS-DPKVHU
Adult Companion 372600000X C10261214 CA Primary

Addresses

Primary practice location

800 Scenic Dr
Modesto, CA 95350-6131

Mailing address

2619 Ward Ave
Riverbank, CA 95367-2718
Phone (209) 622-8516

Other identifiers 1

IdentifierTypeStateIssuer
17500000XMedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
C10261214CAMDAdult Companion

NPI Registry JSON

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

{
    "created_epoch": "1392768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747785600000",
    "number": "1295150837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2619 WARD AVE",
            "city": "RIVERBANK",
            "state": "CA",
            "postal_code": "953672718",
            "telephone_number": "209-622-8516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 SCENIC DR",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953506131",
            "telephone_number": "209-525-6150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "credential": "CADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-02-19",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "C10261214",
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": "MPSS-DPKVHU",
            "primary": false
        },
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": "CA",
            "license": "C10261214",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "17500000X",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2025; 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.