Provider Demographics
NPI:1558489591
Name:BRATSKY, JOSEPH HENRY (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:HENRY
Last Name:BRATSKY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3252 HOLIDAY CT. #106
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-1807
Mailing Address - Country:US
Mailing Address - Phone:858-552-8181
Mailing Address - Fax:858-552-0205
Practice Address - Street 1:3252 HOLIDAY CT STE 106
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1807
Practice Address - Country:US
Practice Address - Phone:858-552-8181
Practice Address - Fax:858-552-0205
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2012-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY7112103TA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)