NPIMap

Individual provider Active NPI

Tanya Miller, COTA/L

  • Contractor
  • Carson, CA
National Provider Identifier
1497052062
Registry record updated Feb 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
License
969732 Issued in CA
Practice address
1 Civic Plaza Dr Ste 625
Carson, CA 90745-7986
Phone
(310) 549-4500
Fax
(310) 549-4700
NPI assigned
Feb 17, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X 969732 CA Primary

Addresses

Primary practice location

1 Civic Plaza Dr Ste 625
Carson, CA 90745-7986

Mailing address

1 Civic Plaza Dr Ste 625
Carson, CA 90745-7986
Phone (310) 549-4500

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
969732CAMDContractor

Practice roles

OrganizationSpecialtyStatusNew patients
Supplemental Health Care Past Accepting new patients
Supplemental Health Care Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1297900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297900800000",
    "number": "1497052062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CIVIC PLAZA DR STE 625",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907457986",
            "telephone_number": "310-549-4500",
            "fax_number": "310-549-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CIVIC PLAZA DR STE 625",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907457986",
            "telephone_number": "310-549-4500",
            "fax_number": "310-549-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "TANYA",
        "name_prefix": "Miss",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-17",
        "last_updated": "2011-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "CA",
            "license": "969732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carson, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2011; 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.