Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 27354 | CA |
Y | 103T00000X | Psychologist | 27354 | CA |
NPI | 1013386531 |
---|---|
Provider Name | Dr. Joseph Miller |
First Address | Redwood City, CA 94065-1536 |
Second Address | Mountain View, CA 94040-2336 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2015 |
Last Update Date | 15/09/2015 |