Provider Demographics
NPI:1053118281
Name:DESSER, MICHELE (ATC)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:DESSER
Suffix:
Gender:
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 EATON ST APT A
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054-6504
Mailing Address - Country:US
Mailing Address - Phone:814-746-9656
Mailing Address - Fax:
Practice Address - Street 1:6451 EL CAMINO REAL # B-2
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92009-2800
Practice Address - Country:US
Practice Address - Phone:814-746-9656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-26
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer