Active NPI
Sandra Janeane Miller
- Clinical Social Worker
- Clearlake, CA
National Provider Identifier
1639883416
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- ASW108302
- Practice address
- 15320 Lakeshore Dr.
Clearlake, CA 95422 - Phone
- (707) 995-4577
- Fax
- (707) 995-4560
- NPI assigned
- Jan 6, 2023
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | ASW108302 | CA | Primary |
Addresses
Primary practice location
15320 Lakeshore Dr.
Clearlake, CA 95422
Mailing address
15320 Lakeshore Dr.
Clearlake, CA 95422
Phone (707) 995-4577
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | millersj01@ah.org | Direct | |
| Direct Messaging Address | millersj01@ah.org | Direct |
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 |
|---|---|---|---|
| ASW108302 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1672963200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1672963200000",
"number": "1639883416",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15320 LAKESHORE DR.",
"city": "CLEARLAKE",
"state": "CA",
"postal_code": "95422",
"telephone_number": "707-995-4577",
"fax_number": "707-995-4560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15320 LAKESHORE DR.",
"city": "CLEARLAKE",
"state": "CA",
"postal_code": "95422",
"telephone_number": "707-995-4577",
"fax_number": "707-995-4560"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "SANDRA",
"middle_name": "JANEANE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-01-06",
"last_updated": "2023-01-06",
"certification_date": "2023-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "ASW108302",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "millersj01@ah.org",
"affiliation": "N",
"endpointDescription": "work email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "15230 Lakeshore Dr",
"city": "Clearlake",
"state": "CA",
"country_code": "US",
"postal_code": "954228107",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "millersj01@ah.org",
"affiliation": "N",
"endpointDescription": "employment email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "email",
"address_1": "15230 Lakeshore Dr",
"city": "Clearlake",
"state": "CA",
"country_code": "US",
"postal_code": "954228107",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Clearlake, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.