Provider Demographics
NPI:1134973464
Name:BRATTI, PETER G
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:G
Last Name:BRATTI
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 JIRON ST
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-1050
Mailing Address - Country:US
Mailing Address - Phone:415-505-9336
Mailing Address - Fax:
Practice Address - Street 1:610 JIRON ST
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-1050
Practice Address - Country:US
Practice Address - Phone:415-505-9336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-15
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No251S00000XAgenciesCommunity/Behavioral Health