Healthcare Provider Details

I. General information

NPI: 1831251719
Provider Name (Legal Business Name): JEFFREY MILLEGAN MD, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2006
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 CLAY ST
OAKLAND CA
94612-1425
US

IV. Provider business mailing address

26565 AGOURA RD STE 200
CALABASAS CA
91302-1990
US

V. Phone/Fax

Practice location:
  • Phone: 510-752-1075
  • Fax:
Mailing address:
  • Phone: 844-672-4863
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD-22374
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA84799
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: