Healthcare Provider Details

I. General information

NPI: 1053809772
Provider Name (Legal Business Name): MEGAN ALISE MILLER PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2018
Last Update Date: 02/03/2026
Certification Date: 02/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43 QUAIL CT STE 201
WALNUT CREEK CA
94596-8703
US

IV. Provider business mailing address

43 QUAIL CT STE 201
WALNUT CREEK CA
94596-8703
US

V. Phone/Fax

Practice location:
  • Phone: 925-954-1618
  • Fax:
Mailing address:
  • Phone: 530-400-3836
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number94029310
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: