Provider Demographics
NPI:1033327473
Name:MILLER, DAVID JOEL (LMFT)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:JOEL
Last Name:MILLER
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3134 WILLOW AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93612-4747
Mailing Address - Country:US
Mailing Address - Phone:559-977-0614
Mailing Address - Fax:559-453-5700
Practice Address - Street 1:3134 WILLOW AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93612-4747
Practice Address - Country:US
Practice Address - Phone:559-977-0614
Practice Address - Fax:559-453-5700
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC45390106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist