Provider Demographics
NPI:1760527857
Name:BRATCHER, BRIAN LEIGH (MHRS)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:LEIGH
Last Name:BRATCHER
Suffix:
Gender:M
Credentials:MHRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7052 SILVER GLEN WAY
Mailing Address - Street 2:
Mailing Address - City:RIO LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:95673-2232
Mailing Address - Country:US
Mailing Address - Phone:916-991-4287
Mailing Address - Fax:
Practice Address - Street 1:7000 FRANKLIN BLVD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-1820
Practice Address - Country:US
Practice Address - Phone:916-394-9195
Practice Address - Fax:916-394-2827
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2009-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA02996171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA02993OtherCOUNTY MEDICAL BILLING #