Healthcare Provider Details

I. General information

NPI: 1255120036
Provider Name (Legal Business Name): WENDY MILES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2025
Last Update Date: 05/06/2025
Certification Date: 05/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8210 S BRIGHT RD
FRENCH CAMP CA
95231-9759
US

IV. Provider business mailing address

3123 INDEPENDENCE DR
LIVERMORE CA
94551-7595
US

V. Phone/Fax

Practice location:
  • Phone: 925-409-7925
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: