Healthcare Provider Details

I. General information

NPI: 1417347709
Provider Name (Legal Business Name): YVONNE MILLER MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/26/2015
Last Update Date: 01/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 E CENTER ST
ANAHEIM CA
92805-3457
US

IV. Provider business mailing address

1901 E CENTER ST
ANAHEIM CA
92805-3457
US

V. Phone/Fax

Practice location:
  • Phone: 714-780-0750
  • Fax: 714-780-0757
Mailing address:
  • Phone: 714-780-0750
  • Fax: 714-780-0757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number80794
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: