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NPI Code Detail

MEDICARE: MR. CORWIN C. VON MILLER IV LMFT

MEDICARE:  MR. CORWIN C. VON MILLER IV LMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family TherapistMFC47325CA

General Provider Information

NPI Number : 1285645119
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. CORWIN C. VON MILLER IV LMFT
Provider Business Mailing Address
First Line : 3331 POWER INN RD STE 180
Second Line :
City : SACRAMENTO
State : CA
Zip : 95826-3889
Country : US
Telephone Number : 916-875-3371
Fax Number : 916-875-6904
Provider Business Practice Location Address
First Line : 2040 ETHAN WAY RM 13
Second Line :
City : SACRAMENTO
State : CA
Zip : 95825-0118
Country : US
Telephone Number : 916-566-2027
Fax Number : 916-566-2003
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2006
Last Update Date : 12/17/2010

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Directions to “ MR. CORWIN C. VON MILLER IV LMFT” Practice Location

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