MEDICARE: DENISE ALDERETE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1316270440
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENISE ALDERETE

Provider Business Mailing Address
First Line	:	2119 54TH ST
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92105-5409
Country	:	US
Telephone Number	:	619-997-3250
Fax Number	:

Provider Business Practice Location Address
First Line	:	2119 54TH ST
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92105-5409
Country	:	US
Telephone Number	:	619-997-3250
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/08/2009
Last Update Date	:	09/08/2009

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