Provider Demographics
NPI:1245559574
Name:MILLER, AMY ROSE VERBONICH (PSYD)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:ROSE VERBONICH
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 1:3092 SNELL PL
Mailing Address - Street 2:
Mailing Address - City:MARINA
Mailing Address - State:CA
Mailing Address - Zip Code:93933-2815
Mailing Address - Country:US
Mailing Address - Phone:831-288-2758
Mailing Address - Fax:
Practice Address - Street 1:3092 SNELL PL
Practice Address - Street 2:
Practice Address - City:MARINA
Practice Address - State:CA
Practice Address - Zip Code:93933-2815
Practice Address - Country:US
Practice Address - Phone:831-288-2758
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-26
Last Update Date:2025-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional