Healthcare Provider Details

I. General information

NPI: 1073894218
Provider Name (Legal Business Name): CAITLIN MILLER CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2011
Last Update Date: 03/03/2025
Certification Date: 03/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2637 SHADELANDS DR
WALNUT CREEK CA
94598-2512
US

IV. Provider business mailing address

2637 SHADELANDS DR
WALNUT CREEK CA
94598-2512
US

V. Phone/Fax

Practice location:
  • Phone: 925-945-6600
  • Fax: 925-945-7842
Mailing address:
  • Phone: 925-945-6600
  • Fax: 925-945-7842

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberNMF1965
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number1965
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: