Provider Demographics
NPI:1043998560
Name:MIRAMONTES, HEATHER LADAWN
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:LADAWN
Last Name:MIRAMONTES
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:LADAWN
Other - Last Name:CURTIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3020 OCEANSIDE BLVD APT 104
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054-4835
Mailing Address - Country:US
Mailing Address - Phone:760-716-9845
Mailing Address - Fax:
Practice Address - Street 1:321 CASSIDY ST
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-5314
Practice Address - Country:US
Practice Address - Phone:760-721-2171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-05
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner