Provider Demographics
NPI:1427104629
Name:MILLER, NANCY G (MA, MFT)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:G
Last Name:MILLER
Suffix:
Gender:F
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1990 3RD ST
Mailing Address - Street 2:SUITE 600
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95814-6929
Mailing Address - Country:US
Mailing Address - Phone:916-455-8169
Mailing Address - Fax:
Practice Address - Street 1:1990 3RD ST
Practice Address - Street 2:SUITE 600
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95814-6929
Practice Address - Country:US
Practice Address - Phone:916-455-8169
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8638106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist