Provider Demographics
NPI:1720387772
Name:RATEKIN, BECKY L (LMFT, ATR)
Entity Type:Individual
Prefix:
First Name:BECKY
Middle Name:L
Last Name:RATEKIN
Suffix:
Gender:F
Credentials:LMFT, ATR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 312
Mailing Address - Street 2:
Mailing Address - City:WEIMAR
Mailing Address - State:CA
Mailing Address - Zip Code:95736-0312
Mailing Address - Country:US
Mailing Address - Phone:530-906-6507
Mailing Address - Fax:530-637-4137
Practice Address - Street 1:884 LINCOLN WAY STE 34B
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603-4830
Practice Address - Country:US
Practice Address - Phone:530-906-6507
Practice Address - Fax:530-637-4137
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-16
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48007106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist