Provider Demographics
NPI:1154112720
Name:SADAVRATI, PRATICHI RUTURAJ (AMFT)
Entity type:Individual
Prefix:MS
First Name:PRATICHI
Middle Name:RUTURAJ
Last Name:SADAVRATI
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 IMPERIAL HWY STE 105
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835-1047
Mailing Address - Country:US
Mailing Address - Phone:714-468-5441
Mailing Address - Fax:
Practice Address - Street 1:211 IMPERIAL HWY STE 105
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835-1047
Practice Address - Country:US
Practice Address - Phone:714-468-5441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-14
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA154149106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist