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General NPI Number Information
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NPI Number | 1790216117
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Entity Type | Individual
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Provider Name | MIREYA MILLAN
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Gender | Female
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Dates
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Enumeration Date | 03/27/2017
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Last Update Date | 03/27/2017
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Provider Practice Location Address
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Address Line | 340 RANCHEROS DR 166
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City | SAN MARCOS
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State | CA
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Zip | 92069-2900
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Country | US
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Telephone | 760-744-3672
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Fax | 760-744-6182
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Provider Business Mailing Address
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Address Line | 3401 LOS MOCHIS WAY
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City | OCEANSIDE
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State | CA
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Zip | 92056-4717
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Country | US
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Telephone | 760-458-9300
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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