Provider Demographics
NPI:1518167683
Name:MILLER, JILL (PSYD)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5275 CLAREMONT AVE
Mailing Address - Street 2:CENTER FOR THE VULNERABLE CHILD
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94618-1032
Mailing Address - Country:US
Mailing Address - Phone:510-428-3885
Mailing Address - Fax:510-601-3913
Practice Address - Street 1:5275 CLAREMONT AVE
Practice Address - Street 2:CENTER FOR THE VULNERABLE CHILD
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94618-1032
Practice Address - Country:US
Practice Address - Phone:510-428-3885
Practice Address - Fax:510-601-3913
Is Sole Proprietor?:No
Enumeration Date:2007-07-18
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent