Provider Demographics
NPI:1376337345
Name:ALTAMIRANO, DESIREE MONIQUE
Entity type:Individual
Prefix:
First Name:DESIREE
Middle Name:MONIQUE
Last Name:ALTAMIRANO
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:433 S ORANGE AVE APT D
Mailing Address - Street 2:
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91755-7526
Mailing Address - Country:US
Mailing Address - Phone:626-602-6471
Mailing Address - Fax:
Practice Address - Street 1:433 S ORANGE AVE APT D
Practice Address - Street 2:
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91755-7526
Practice Address - Country:US
Practice Address - Phone:626-602-6471
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered