Healthcare Provider Details

I. General information

NPI: 1134639859
Provider Name (Legal Business Name): ASPIRE NEURO PSYCHOLOGICAL SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2017
Last Update Date: 06/30/2021
Certification Date: 06/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2815 MITCHELL DR STE 119
WALNUT CREEK CA
94598-1622
US

IV. Provider business mailing address

802 MORNINGSIDE WAY
PLEASANT HILL CA
94523-2467
US

V. Phone/Fax

Practice location:
  • Phone: 925-885-6070
  • Fax: 925-835-7071
Mailing address:
  • Phone: 925-885-6070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number28008
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number28008
License Number StateCA

VIII. Authorized Official

Name: DR. KEIKO Y MILLER
Title or Position: OWNER/CEO
Credential: PSY.D.
Phone: 925-885-6070