Provider Demographics
NPI:1750432316
Name:MILLER, RENEE K (LMFT)
Entity type:Individual
Prefix:MRS
First Name:RENEE
Middle Name:K
Last Name:MILLER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4141 FRUITVALE AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94602-2517
Mailing Address - Country:US
Mailing Address - Phone:510-530-3648
Mailing Address - Fax:510-530-3648
Practice Address - Street 1:4141 FRUITVALE AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94602-2517
Practice Address - Country:US
Practice Address - Phone:510-530-3648
Practice Address - Fax:510-530-3648
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC41437101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health