Provider Demographics
NPI:1922372192
Name:RATCLIFFE, CAITLYN (ATC)
Entity Type:Individual
Prefix:
First Name:CAITLYN
Middle Name:
Last Name:RATCLIFFE
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:904 SARTORI AVE
Mailing Address - Street 2:#2
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90501-2275
Mailing Address - Country:US
Mailing Address - Phone:206-375-9837
Mailing Address - Fax:310-516-3710
Practice Address - Street 1:904 SARTORI AVE
Practice Address - Street 2:#2
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90501-2275
Practice Address - Country:US
Practice Address - Phone:206-375-9837
Practice Address - Fax:310-516-3710
Is Sole Proprietor?:No
Enumeration Date:2012-03-05
Last Update Date:2016-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARATCLCL128LZ2255A2300X
CAF49548172255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA22OtherPROVIDER