Provider Demographics
NPI:1023212875
Name:MILMAN, JEFFREY ALAN (PHD)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:ALAN
Last Name:MILMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:570 LAKE SHERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LAKE SHERWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91361-5120
Mailing Address - Country:US
Mailing Address - Phone:805-373-6570
Mailing Address - Fax:805-388-3456
Practice Address - Street 1:570 LAKE SHERWOOD DR
Practice Address - Street 2:
Practice Address - City:LAKE SHERWOOD
Practice Address - State:CA
Practice Address - Zip Code:91361-5120
Practice Address - Country:US
Practice Address - Phone:805-373-6570
Practice Address - Fax:805-388-3456
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11238103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical