Healthcare Provider Details

I. General information

NPI: 1013386531
Provider Name (Legal Business Name): JOSEPH MILLER PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2015
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39 N SAN MATEO DR STE 7
SAN MATEO CA
94401-2832
US

IV. Provider business mailing address

14 ARROYO VIEW CIR
BELMONT CA
94002-3184
US

V. Phone/Fax

Practice location:
  • Phone: 415-722-8130
  • Fax:
Mailing address:
  • Phone: 415-722-8130
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number27354
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: