Healthcare Provider Details

I. General information

NPI: 1639426307
Provider Name (Legal Business Name): SCOTT THOMAS MILLER CA LMFT 129223
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: SCOTT THOMAS MILLER HI MFT-876-0

II. Dates (important events)

Enumeration Date: 08/13/2012
Last Update Date: 09/29/2024
Certification Date: 09/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5601 ARNOLD RD STE 160
DUBLIN CA
94568-7724
US

IV. Provider business mailing address

2730 SHADELANDS DR BLDG 10
WALNUT CREEK CA
94598-2538
US

V. Phone/Fax

Practice location:
  • Phone: 925-248-9925
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number876-0
License Number StateHI
# 3
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number103477
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: