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Individual

MICHAEL A MILLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CADC

Contact information

Practice address
800 SCENIC DR, MODESTO, CA 95350-6131
(209) 525-6150
Mailing address
2619 WARD AVE, RIVERBANK, CA 95367-2718
(209) 622-8516

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
C10261214
CA
101YA0400X
Addiction (Substance Use Disorder) Counselor
175T00000X
Peer Specialist
MPSS-DPKVHU
372600000X
Adult Companion
Primary
C10261214
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
17500000X
CA
Enumeration date
02/19/2014
Last updated
05/21/2025
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