Provider Demographics
NPI:1417604745
Name:CRATTY, JULIA RACHELLE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:RACHELLE
Last Name:CRATTY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:571 ACADIA DR
Mailing Address - Street 2:
Mailing Address - City:PETALUMA
Mailing Address - State:CA
Mailing Address - Zip Code:94954-6683
Mailing Address - Country:US
Mailing Address - Phone:707-933-6420
Mailing Address - Fax:
Practice Address - Street 1:2798 YULUPA AVE STE A
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95405-8570
Practice Address - Country:US
Practice Address - Phone:707-527-4001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-07
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA301834225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist