DESIRAE PEROUZ MILLER (NPI# 1588932248) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1588932248 |
Entity Type | Individual |
Full Name | DESIRAE PEROUZ MILLER |
Credential | CADC-CAS |
Practice Address |
310 Harbor Blvd Bldg E Belmont CA 94002-4018 |
Mailing Address |
124 27th Ave San Mateo CA 94403-2496 |
Practice Telephone | 6508026468 |
Mailing Telephone | 6504309867 |
Mailing Fax Number | 6503558780 |
Enumeration Date | 2011-12-09 |
Last Update Date | 2019-06-13 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
CA | CALIFORNIA CONSORTIUM OF ADDICTION PROGRAMS AND PROFESSIONALS | C05591518 | 01 |
CA | REGISTERED ADDICTION SPECIALIST INTERN (RASI) | RI-M1104291258 | 01 |
Address | Telephone Number | Fax Number |
---|---|---|
480 Manor Plz, Pacifica, CA 940441839 | 6503558787 | 6503558780 |
550 Quarry Rd Fl 3rs, San Carlos, CA 940706221 | 6505086745 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1326507609 | Desirae Miller | Midwife, Lay | 10 Rock St, Middletown, PA 17057-4644 | 2019-03-18 |
Street Address |
310 HARBOR BLVD BLDG E |
City | BELMONT |
State | CA |
Zip Code | 94002-4018 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1225465040 | Mark Edward Ross | Counselor | 310 Harbor Blvd Bldg E, Belmont, CA 94002-4018 | 2013-10-11 |
1538506530 | Stella Ka Yuen Chau | Behavioral Analyst | 310 Harbor Blvd Bldg E, Belmont, CA 94002-4018 | 2013-05-30 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1740728740 | Simon Hirschl | Pathology | 9 Kittie Lane, Belmont, CA 94002 | 2017-02-09 |
1902251028 | Emma Yan Hiu Lee Chou | Occupational Therapist | 2410 Carlmont Dr, Belmont, CA 94002 | 2016-04-26 |
1740578087 | The Latino Commisson | Substance Abuse Rehabilitation Facility | 401 Briarfield Way, Belmont, CA 94002 | 2011-07-20 |
1053624189 | Pragya Jain | Internal Medicine | 1301 Shoreway Rd., Ste. 100, Belmont, CA 94002 | 2010-07-18 |
1194956425 | Lilia Patricia Gallegos | Marriage & Family Therapist | 1 Davis Drive, Belmont, CA 94002 | 2009-08-04 |
1407099088 | Dharmesh Patel | Radiology | 513 Seagate Way, Belmont, CA 94002 | 2009-04-13 |
1376688044 | Paul M. Takla | Dentist | 2130 Ralston Ave, Suite 1e, Belmont, CA 94002 | 2007-02-21 |
1487799987 | Mark Joseph Mcmahon | Physical Therapist | 549 Ralson Avenue, Suite B, Belmont, CA 94002 | 2007-02-21 |
1639216112 | Patricia Mary Wieser | Nurse Practitioner | 1541 Harbor Blvd, Belmont, CA 94002 | 2007-01-31 |
1063575157 | Peninsula Specialty Care | Dentist | 562 Ralston Ave, Belmont, CA 94002 | 2006-12-19 |
Find all providers in zip 94002 |
Taxonomy Code | 101YA0400X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Counselor |
Specialization | Addiction (Substance Use Disorder) |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1093322364 | Northstar Wellness Associates Pllc | Counselor | 171 Daniel Webster Hwy Unit 11, Belmont, NH 03220-3053 | 2020-09-30 |
1033760376 | Joshua Booth | Counselor | 41418 Stenger Road, Belmont, OH 43718-4371 | 2019-09-27 |
1063075620 | Cassandre Noelle Durand | Counselor | 184 Fellows Hill Rd, Belmont, NH 03220-4498 | 2019-04-19 |
1871062877 | Julie Ruano | Counselor | 1101 Village Dr Apt 2, Belmont, CA 94002-3445 | 2018-11-19 |
1104345883 | Virginia Lucille Samuels | Counselor | 116 East Main Street, Belmont, OH 43718 | 2017-09-14 |
1568918985 | Xavier Laporte-sanchez | Counselor | 125 Oak Trl, Belmont, NC 28012-2705 | 2016-08-26 |
1538556923 | Lewis Chase II | Counselor | 6215 Maksimowski Ave Ne, Belmont, MI 49306-9700 | 2015-04-23 |
1295082543 | Rogelio Salinas Jr. | Counselor | 2151 Carlmont Dr, #206, Belmont, CA 94002-3453 | 2012-08-06 |
1710263918 | Nicole Lynne Siegel | Counselor | 27 Hermon St, Belmont, MA 02478-2624 | 2011-11-01 |
1972885598 | Michelle Marie Watkins | Counselor | 32 N Main St Ste 204, Belmont, NC 28012 | 2011-09-10 |
Find all providers in BELMONT |
Please comment or provide details below to improve the information on DESIRAE PEROUZ MILLER.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.