Individual
BRAD MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
9666 BUSINESSPARK AVE, SUITE 106, SAN DIEGO, CA 92131-1646
(858) 549-3031
Mailing address
9666 BUSINESSPARK AVE, SUITE 106, SAN DIEGO, CA 92131-1646
(858) 549-3031
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY 17229
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PSY 172290
—
CA
Enumeration date
02/02/2007
Last updated
07/08/2007
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