Provider Demographics
NPI:1316270440
Name:ALDERETE, DENISE
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:ALDERETE
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 1:2119 54TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92105-5409
Mailing Address - Country:US
Mailing Address - Phone:619-997-3250
Mailing Address - Fax:
Practice Address - Street 1:2119 54TH ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92105-5409
Practice Address - Country:US
Practice Address - Phone:619-997-3250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-08
Last Update Date:2009-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health