Provider Demographics
NPI:1770399495
Name:MILLER, JASON (CADC II)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:MILLER
Suffix:
Gender:M
Credentials:CADC II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:631 S BROOKHURST ST STE 104
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92804-3510
Mailing Address - Country:US
Mailing Address - Phone:714-620-8131
Mailing Address - Fax:714-620-8132
Practice Address - Street 1:631 S BROOKHURST ST STE 104
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804-3510
Practice Address - Country:US
Practice Address - Phone:714-620-8131
Practice Address - Fax:714-620-8132
Is Sole Proprietor?:No
Enumeration Date:2024-12-06
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist