Katrina R Millet, LCSW, PHD

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

109879 Issued in CA

Practice address

1110 W Anaheim St Ste 8
Wilmington, CA 90744-4131

Phone

(310) 872-3560

NPI assigned

Oct 25, 2022

Last updated

Oct 25, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1666656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1790402295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1392",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923341392",
            "telephone_number": "909-232-0700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 W ANAHEIM ST STE 8",
            "city": "WILMINGTON",
            "state": "CA",
            "postal_code": "907444131",
            "telephone_number": "310-872-3560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLET",
        "first_name": "KATRINA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "LCSW, PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-25",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "109879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "ICANNOTES",
            "affiliation": "N",
            "endpointDescription": "ICANNOTES",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1110 W Anaheim St Ste 8",
            "city": "Wilmington",
            "state": "CA",
            "country_code": "US",
            "postal_code": "907444131",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ann Margaret McClure, R.D.A.
• William Loushion McCollum
• Fantaye Merid, M.D.
• Maria Yolanda Meza, PHARMD
• Thecla N. Mgbojirikwe, M.D.
• Jimmy Dion Mitchell Jr.
• Molina Healthcare of California
• Ehsan Montazeri, MD
• Clarence Canlapan Monteclaro, MD, MBA
• Dionisio Maneja Montenegro, M.D.

• Clinical Social Worker in Wilmington, CA
• Providers in Wilmington, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.

Verify at the official NPI Registry.