Healthcare Provider Details

I. General information

NPI: 1972038289
Provider Name (Legal Business Name): MEGAN MILLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2017
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 SHAFFER RD
SANTA CRUZ CA
95060-5761
US

IV. Provider business mailing address

1201 SHAFFER RD
SANTA CRUZ CA
95060-5761
US

V. Phone/Fax

Practice location:
  • Phone: 831-336-5196
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: