Basic Information
| Provider Information | |||||||||
| NPI: | 1922168780 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MILES | ||||||||
| FirstName: | RADHIKA | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | LMFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 822 A ST | ||||||||
| Address2: | |||||||||
| City: | CROCKETT | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945251407 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5107873241 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2311 LOVERIDGE RD | ||||||||
| Address2: | |||||||||
| City: | PITTSBURG | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945655117 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9254312654 | ||||||||
| FaxNumber: | 9254312644 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/11/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | MFC41548 | CA | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.