=====================================================
General NPI Number Information
=====================================================
NPI Number | 1548637929
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MR. ARTURO ALTAMIRANO SERMENO
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/01/2015
-----------------------------------------------------
Last Update Date | 03/13/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7001 EAST PKWY
-----------------------------------------------------
City | SACRAMENTO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95823-2501
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 916-508-4241
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 531 CAPPS LN APT 60
-----------------------------------------------------
City | UKIAH
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95482-7253
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 707-380-9117
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | 150355
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------