Provider Demographics
NPI:1730872557
Name:MILLER, DEVYON ANDREW
Entity type:Individual
Prefix:
First Name:DEVYON
Middle Name:ANDREW
Last Name:MILLER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12004 AURORA VALLEY AVE
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93312-6772
Mailing Address - Country:US
Mailing Address - Phone:661-474-0550
Mailing Address - Fax:
Practice Address - Street 1:12004 AURORA VALLEY AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93312-6772
Practice Address - Country:US
Practice Address - Phone:661-474-0550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-29
Last Update Date:2023-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician