Provider Demographics
NPI:1417672494
Name:ALTAMIRANO, SIENNA NATALIE
Entity Type:Individual
Prefix:
First Name:SIENNA
Middle Name:NATALIE
Last Name:ALTAMIRANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95678-2232
Mailing Address - Country:US
Mailing Address - Phone:916-724-5053
Mailing Address - Fax:
Practice Address - Street 1:124 MAIN ST
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95678-2232
Practice Address - Country:US
Practice Address - Phone:916-724-5053
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-11
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator