Active NPI
LD Miller, PHD
- Clinical Psychologist
- Redlands, CA
National Provider Identifier
1700843893
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY7764
- Practice address
- 101 E Redlands Blvd
234
Redlands, CA 92373 - Phone
- (909) 335-3026
- Fax
- (909) 335-3167
- NPI assigned
- May 1, 2006
- Sex
- Male
- Sole proprietor
- No
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 Psychologist | 103TC0700X | PSY7764 | CA | Primary |
Addresses
Primary practice location
101 E Redlands Blvd
234
Redlands, CA 92373
Mailing address
101 E Redlands Blvd
#234
Redlands, CA 92373
Phone (909) 335-3026
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY7764 | CA | MD | Clinical Psychologist |
| 7764 | CA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dignity Health Medical Foundation | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Dignity Health Medical Group - Inland Empire, a service of Dignity Hea
- Multi-Specialty Clinic/Center
- Highland, CA
- NPI 1053653873
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146441600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1700843893",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 E REDLANDS BLVD",
"address_2": "#234",
"city": "REDLANDS",
"state": "CA",
"postal_code": "92373",
"telephone_number": "909-335-3026",
"fax_number": "909-335-3167"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 E REDLANDS BLVD",
"address_2": "234",
"city": "REDLANDS",
"state": "CA",
"postal_code": "92373",
"telephone_number": "909-335-3026",
"fax_number": "909-335-3167"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "LD",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-01",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY7764",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redlands, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.