Healthcare Provider Details

I. General information

NPI: 1912813684
Provider Name (Legal Business Name): AUSTIN MUELLER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7810 ARROYO CIR
GILROY CA
95020-7309
US

IV. Provider business mailing address

18034 MCDOWELL ST
MARINA CA
93933-4980
US

V. Phone/Fax

Practice location:
  • Phone: 669-205-4000
  • Fax:
Mailing address:
  • Phone: 669-205-5100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number260151161
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: