Provider Demographics
NPI:1720442965
Name:MILLER, KEIKO YAFA (PSYD, MSCP)
Entity Type:Individual
Prefix:DR
First Name:KEIKO
Middle Name:YAFA
Last Name:MILLER
Suffix:
Gender:F
Credentials:PSYD, MSCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:802 MORNINGSIDE WAY
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-2467
Mailing Address - Country:US
Mailing Address - Phone:925-885-6070
Mailing Address - Fax:
Practice Address - Street 1:2815 MITCHELL DR STE 119
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-1622
Practice Address - Country:US
Practice Address - Phone:925-885-6070
Practice Address - Fax:925-835-7071
Is Sole Proprietor?:No
Enumeration Date:2016-04-13
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103G00000X
CAPSY28008103TB0200X
CA28008103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral