Active NPI
Ruth L Millican
- Psychologist
- San Diego, CA
National Provider Identifier
1346472305
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY25354
- Practice address
- 1963 4TH Ave
San Diego, CA 92101-2394 - Phone
- (619) 233-3432
- Fax
- (619) 233-7022
- NPI assigned
- Aug 10, 2009
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY25354 | CA | Primary |
| Mental Health Counselor | 101YM0800X |
Addresses
Primary practice location
1963 4TH Ave
San Diego, CA 92101-2394
Mailing address
1963 4TH Ave
San Diego, CA 92101-2394
Phone (619) 233-3432
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Health Centers of San Diego Inc | Current | Accepting new patients | |
| Family Health Centers of San Diego, Inc | Current | Accepting new patients | |
| Family Health Centers of San Diego, Inc | Current | Accepting new patients | |
| Community Research Foundation Inc | Past | Accepting new patients | |
| Community Research Foundation Inc | Past | Accepting new patients |
Locations
823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323
3544 30th St
San Diego, CA 92104
Phone (619) 515-2424
Organizations & group practices 5
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.
-
- Federally Qualified Health Center (FQHC)
- San Diego, CA
- NPI 1447281936
-
- Federally Qualified Health Center (FQHC)
- San Diego, CA
- NPI 1235521782
-
- Federally Qualified Health Center (FQHC)
- Escondido, CA
- NPI 1356178180
-
- Community/Behavioral Health Agency
- San Diego, CA
- NPI 1689792533
-
- Community/Behavioral Health Agency
- San Diego, CA
- NPI 1952328700
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1249862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1734912000000",
"number": "1346472305",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1963 4TH AVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921012394",
"telephone_number": "619-233-3432",
"fax_number": "619-233-7022"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1963 4TH AVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921012394",
"telephone_number": "619-233-3432",
"fax_number": "619-233-7022"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLICAN",
"first_name": "RUTH",
"middle_name": "L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-08-10",
"last_updated": "2024-12-23",
"certification_date": "2024-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY25354",
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"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 Dec 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.