Individual
JARED MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RADT
Contact information
Practice address
31764 CASINO DR # 200, LAKE ELSINORE, CA 92530-2312
(951) 471-4649
(951) 471-4687
Mailing address
5870 ARLINGTON AVE, RIVERSIDE, CA 92504-2037
(951) 683-6596
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
MPSS-QYTVPJ
CA
175T00000X
Peer Specialist
R1476710722
CA
Other
Enumeration date
08/30/2022
Last updated
05/13/2024
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