Active NPI
Sandra Maureen Miller, LMFT
- Marriage & Family Therapist
- Tustin, CA
National Provider Identifier
1467799882
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 47780
- Practice address
- 17772 Irvine Boulevard
Suite 101
Tustin, CA 92780 - Phone
- (949) 572-7600
- NPI assigned
- Jan 4, 2013
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 47780 | CA | Primary |
Addresses
Primary practice location
17772 Irvine Boulevard
Suite 101
Tustin, CA 92780
Mailing address
PO Box 4103
Mission Viejo, CA 92690
Phone (949) 572-7600
Other names 1
- Mrs. Sandra Maureen Miller
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
| License | State | Type | Specialty |
|---|---|---|---|
| 47780 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1357257600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1357257600000",
"number": "1467799882",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4103",
"city": "MISSION VIEJO",
"state": "CA",
"postal_code": "92690",
"telephone_number": "949-572-7600",
"fax_number": "949-451-5467"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17772 IRVINE BOULEVARD",
"address_2": "SUITE 101",
"city": "TUSTIN",
"state": "CA",
"postal_code": "92780",
"telephone_number": "949-572-7600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "SANDRA",
"middle_name": "MAUREEN",
"name_prefix": "Mrs.",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-01-04",
"last_updated": "2013-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "47780",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SANDRA",
"last_name": "MILLER",
"middle_name": "MAUREEN",
"prefix": "MRS.",
"credential": "LMFT",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Tustin, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.