Individual provider Active NPI

Amy Marcel Miller, PSY.D.

  • Mental Health Counselor
  • Rancho Cucamonga, CA
National Provider Identifier
1700930112
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
PSY10372 Issued in CA
Practice address
8580 Utica Ave Ste 200
Rancho Cucamonga, CA 91730-4870
Phone
(909) 944-1717
Fax
(909) 948-5199
NPI assigned
Jan 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X PSY10372 CA Primary

Addresses

Primary practice location

8580 Utica Ave Ste 200
Rancho Cucamonga, CA 91730-4870

Mailing address

8580 Utica Ave Ste 200
Rancho Cucamonga, CA 91730-4870
Phone (909) 944-1717

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050104000719 CA Practitioner - Clinical Psychologist 4183672454 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Health Group Psychological Services IncGroup PAC ID 3870779622, 2 clinicians

Practice addresses (Care Compare)

8580 Utica Ave
Rancho Cucamonga, CA 91730-4870

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY10372CAMDMental Health Counselor

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.

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700930112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8580 UTICA AVE STE 200",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917304870",
            "telephone_number": "909-944-1717",
            "fax_number": "909-948-5199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8580 UTICA AVE STE 200",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917304870",
            "telephone_number": "909-944-1717",
            "fax_number": "909-948-5199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "AMY",
        "middle_name": "MARCEL",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "PSY10372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

Verify at the official NPI Registry.