Active NPI
Pamela Joy Miller, M.S.W.
- Clinical Social Worker
- San Rafael, CA
National Provider Identifier
1750621975
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 16855
- Practice address
- 900 5TH Ave Ste 150
San Rafael, CA 94901-2928 - Phone
- (415) 457-6964
- NPI assigned
- Feb 25, 2013
- Last updated
- Feb 25, 2013
- Sex
- Female
- 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 Social Worker | 1041C0700X | 16855 | MD | Primary |
Addresses
Primary practice location
900 5TH Ave Ste 150
San Rafael, CA 94901-2928
Mailing address
7 Indigo Dr Unit 209
Petaluma, CA 94954-7604
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2009
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
PO Box
Dallas, TX 75373
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16855 | MD | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sondermind Provider Network LLC | Clinical | Current | Accepting new patients |
Locations
20 S 3rd St
Ste 210
Columbus, OH 43215
Phone (614) 208-4973
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1361750400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1361750400000",
"number": "1750621975",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7 INDIGO DR UNIT 209",
"city": "PETALUMA",
"state": "CA",
"postal_code": "949547604"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 5TH AVE STE 150",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949012928",
"telephone_number": "415-457-6964"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "PAMELA",
"middle_name": "JOY",
"name_prefix": "Ms.",
"credential": "M.S.W.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-02-25",
"last_updated": "2013-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "16855",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Rafael, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.