Provider Demographics
NPI:1609402650
Name:MILLER, ROBERT JOHN (MA)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:JOHN
Last Name:MILLER
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 HOPECO RD
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-3213
Mailing Address - Country:US
Mailing Address - Phone:925-949-3201
Mailing Address - Fax:
Practice Address - Street 1:3000 CITRUS CIR STE 220
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-2665
Practice Address - Country:US
Practice Address - Phone:925-689-5811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-20
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist