Christel Dizon Miranda, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

C158757 Issued in CA

Practice address

2110 Professional Dr Ste 120
Roseville, CA 95661-3779

Phone

(916) 536-2500

Fax

(916) 780-3904

NPI assigned

Jul 21, 2011

Last updated

Jan 2, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1311206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546387200000",
    "number": "1659669877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DATA DR",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2110 PROFESSIONAL DR STE 120",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613779",
            "telephone_number": "916-536-2500",
            "fax_number": "916-780-3904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRANDA",
        "first_name": "CHRISTEL",
        "middle_name": "DIZON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-21",
        "last_updated": "2019-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "47390",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "C158757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie Lyn Milotz, PSY.D.
• Mindscape Psychiatric Wellness Nursing Corporation (Mindscape Psychiatric Wellness)
• Alizon Edith Minjarez Romero
• Brett Jordan Minkin, R.R.T., N.P.S.
• Rose Minton
• Lisa M Miranda, P.A.-C
• Melissa Miranda
• Mayra Mireles Jacobo
• Lucia Mireles
• Hossein Mirheydar, M.D.

• Family Medicine Physician in Roseville, CA
• Providers in Roseville, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2019; 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.