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General NPI Number Information
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NPI Number | 1134639859
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Entity Type | Organization
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Legal Business Name | ASPIRE NEURO PSYCHOLOGICAL SERVICES, INC.
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Dates
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Enumeration Date | 10/08/2017
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Last Update Date | 06/30/2021
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Provider Practice Location Address
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Address Line | 2815 MITCHELL DR STE 119
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City | WALNUT CREEK
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State | CA
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Zip | 94598-1622
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Country | US
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Telephone | 925-885-6070
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Fax | 925-835-7071
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Provider Business Mailing Address
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Address Line | 802 MORNINGSIDE WAY
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City | PLEASANT HILL
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State | CA
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Zip | 94523-2467
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Country | US
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Telephone | 925-885-6070
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | DR. KEIKO Y MILLER
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Credential | PSY.D.
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Telephone | 925-885-6070
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 28008
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 28008
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License Number State | CA
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