Individual provider Active NPI

Patrea Hibberd-Miller, MFT

  • Marriage & Family Therapist
  • Santa Rosa, CA
National Provider Identifier
1962878520
Registry record updated Aug 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT53814 Issued in CA
Practice address
100 E St Ste 305
Santa Rosa, CA 95404-4607
Phone
(707) 235-7760
NPI assigned
Aug 18, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LMFT53814 CA Primary

Addresses

Primary practice location

100 E St Ste 305
Santa Rosa, CA 95404-4607

Mailing address

15960 Drake Rd
Guerneville, CA 95446-9734
Phone (707) 235-7760

Other names 1

  • Patrea Ann Miller Professional name

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
I20240425002889 CA Practitioner - Marriage and Family Therapist 7315387248 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Psych Strategies Inc a Psychological CorpGroup PAC ID 0446144497, 23 clinicians

Practice addresses (Care Compare)

1160 N Dutton Ave
Suite 230
Santa Rosa, CA 95401-4658
Phone (707) 303-3201

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMFT53814CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Psych Strategies Inc a Psychological Corp CurrentSince Feb 27, 2024 Accepting new patients

Locations

1160 N Dutton Ave
Ste 230
Santa Rosa, CA 95401
Phone (707) 303-3201

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": "1439856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439856000000",
    "number": "1962878520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15960 DRAKE RD",
            "city": "GUERNEVILLE",
            "state": "CA",
            "postal_code": "954469734",
            "telephone_number": "707-235-7760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E ST STE 305",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044607",
            "telephone_number": "707-235-7760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIBBERD-MILLER",
        "first_name": "PATREA",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-18",
        "last_updated": "2015-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT53814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PATREA",
            "last_name": "MILLER",
            "middle_name": "ANN",
            "credential": "MFT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.