Individual provider Active NPI

Renee K. Miller, LMFT

  • Mental Health Counselor
  • Oakland, CA
National Provider Identifier
1750432316
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MFC41437 Issued in CA
Practice address
4141 Fruitvale Ave
Oakland, CA 94602-2517
Phone
(510) 530-3648
Fax
(510) 530-3648
NPI assigned
Jan 12, 2007
Sex
Female
Sole proprietor
Yes

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 MFC41437 CA Primary

Addresses

Primary practice location

4141 Fruitvale Ave
Oakland, CA 94602-2517

Mailing address

4141 Fruitvale Ave
Oakland, CA 94602-2517
Phone (510) 530-3648

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 1, 2024 through Jan 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MFC41437CAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750432316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4141 FRUITVALE AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946022517",
            "telephone_number": "510-530-3648",
            "fax_number": "510-530-3648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4141 FRUITVALE AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946022517",
            "telephone_number": "510-530-3648",
            "fax_number": "510-530-3648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "RENEE",
        "middle_name": "K.",
        "name_prefix": "Mrs.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "MFC41437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.