Provider Demographics
NPI:1225834781
Name:MILLER, BERDIA SHYBREA
Entity type:Individual
Prefix:
First Name:BERDIA
Middle Name:SHYBREA
Last Name:MILLER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3615 LOMA VISTA AVE LOWR REAR
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94619-1421
Mailing Address - Country:US
Mailing Address - Phone:510-395-0119
Mailing Address - Fax:
Practice Address - Street 1:3615 LOMA VISTA AVE LOWR REAR
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94619-1421
Practice Address - Country:US
Practice Address - Phone:510-395-0119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-24
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula