Provider Demographics
NPI:1942011721
Name:ALTAMIRANO-CASTELLANOS, MARIA REBECCA (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:REBECCA
Last Name:ALTAMIRANO-CASTELLANOS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MS
Other - First Name:MARIA
Other - Middle Name:REBECCA
Other - Last Name:CASTELLANOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:734 W LAMONA AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93728-2227
Mailing Address - Country:US
Mailing Address - Phone:559-260-5099
Mailing Address - Fax:
Practice Address - Street 1:1794 ASHLAN AVE
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611-5190
Practice Address - Country:US
Practice Address - Phone:559-294-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-20
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA84854390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program