Provider Demographics
NPI:1942873856
Name:ALTAMIRANO, MARIA SUSANA (RN)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:SUSANA
Last Name:ALTAMIRANO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5363 W AVENUE M8
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93536-3046
Mailing Address - Country:US
Mailing Address - Phone:661-300-0240
Mailing Address - Fax:
Practice Address - Street 1:5363 W AVENUE M8
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93536-3046
Practice Address - Country:US
Practice Address - Phone:661-300-0240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-19
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty