Miller, Gary Michael

Miller, Gary Michael is an individual health care provider with primary practice located at 523 Hayes Ln , Petaluma CA 94952-4011. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Miller, Gary Michael can be contacted via phone (800) 257-8715.

Contact Information

Primary practice address
523 Hayes Ln Petaluma CA 94952-4011
Phone: (800) 257-8715
Fax: (800) 819-1655
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X PSY15695 California

Profile Details

NPI number 1932129327
LBN Legal business name Miller, Gary Michael
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 20th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1932129327 NPPES
California Other PSY156950 RIVERSIDE COUNTY
California Other 0PL156950 RIVERSIDE COUNTY
California MEDICAID PSY156950 RIVERSIDE COUNTY

Popular Providers