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General NPI Number Information
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NPI Number | 1700699683
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Entity Type | Individual
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Provider Name | MILES JOSEPH COOK M.S.
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Gender | Male
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Dates
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Enumeration Date | 01/27/2025
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 970 CAMERADO DR STE 200
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City | CAMERON PARK
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State | CA
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Zip | 95682-7636
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Country | US
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Telephone | 530-677-4404
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Fax |
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Provider Business Mailing Address
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Address Line | 289 WATERFIELD DR
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City | ROSEVILLE
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State | CA
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Zip | 95678-6101
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Country | US
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Telephone | 916-801-4564
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | AMFT152807
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License Number State | CA
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