MEDICARE: DR. KEIKO YAFA MILLER PSY.D., MSCP

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
1	103G00000X	Clinical Neuropsychologist
2	103TB0200X	Cognitive & Behavioral Psychologist	PSY28008	CA
3	103TC0700X	Clinical Psychologist	28008	CA

General Provider Information

NPI Number	:	1720442965
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KEIKO YAFA MILLER PSY.D., MSCP

Provider Business Mailing Address
First Line	:	802 MORNINGSIDE WAY
Second Line	:
City	:	PLEASANT HILL
State	:	CA
Zip	:	94523-2467
Country	:	US
Telephone Number	:	925-885-6070
Fax Number	:

Provider Business Practice Location Address
First Line	:	2815 MITCHELL DR STE 119
Second Line	:
City	:	WALNUT CREEK
State	:	CA
Zip	:	94598-1622
Country	:	US
Telephone Number	:	925-885-6070
Fax Number	:	925-835-7071

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/13/2016
Last Update Date	:	06/30/2021

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