Provider Demographics
NPI:1477754745
Name:MILLER, ERIC
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:MILLER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14840 WAKE AVE
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94578-1805
Mailing Address - Country:US
Mailing Address - Phone:510-875-2300
Mailing Address - Fax:510-875-2310
Practice Address - Street 1:10850 MACARTHUR BLVD
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94605-5266
Practice Address - Country:US
Practice Address - Phone:510-875-2300
Practice Address - Fax:510-875-2310
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-31
Last Update Date:2019-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor