Provider Demographics
NPI:1790306223
Name:ARMSTEAD, DESEREE KIMALEE
Entity Type:Individual
Prefix:
First Name:DESEREE
Middle Name:KIMALEE
Last Name:ARMSTEAD
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 1:169 ROYMAR RD STE A
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92058-1331
Mailing Address - Country:US
Mailing Address - Phone:760-271-4744
Mailing Address - Fax:760-439-2244
Practice Address - Street 1:3753 MISSION AVE STE A-1
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92058-1471
Practice Address - Country:US
Practice Address - Phone:760-271-4744
Practice Address - Fax:760-439-2244
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-06
Last Update Date:2020-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide