Provider Demographics
NPI:1821306713
Name:MILLER, SHERI JANE
Entity Type:Individual
Prefix:MS
First Name:SHERI
Middle Name:JANE
Last Name:MILLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 OLD CROW CANYON RD.
Mailing Address - Street 2:BLDG. 100 STE 112
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583
Mailing Address - Country:US
Mailing Address - Phone:925-362-0683
Mailing Address - Fax:925-363-0680
Practice Address - Street 1:2500 OLD CROW CANYON RD
Practice Address - Street 2:BLDG. 100 STE 112
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-1623
Practice Address - Country:US
Practice Address - Phone:925-362-0683
Practice Address - Fax:925-363-0680
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-14
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2394235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist