Provider Demographics
NPI:1881176659
Name:MILLER, VICTORIA K (LCSW)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:K
Last Name:MILLER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4425C TREAT BLVD # 185
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94521-3552
Mailing Address - Country:US
Mailing Address - Phone:925-695-8899
Mailing Address - Fax:
Practice Address - Street 1:140 MAYHEW WAY STE 902
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-4376
Practice Address - Country:US
Practice Address - Phone:925-695-9899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-29
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA292191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical