Provider Demographics
NPI:1528787264
Name:RATTANATHAM, UBONRAT JOY
Entity type:Individual
Prefix:MRS
First Name:UBONRAT
Middle Name:JOY
Last Name:RATTANATHAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2310 HOMESTEAD RD STE 142
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94024-7339
Mailing Address - Country:US
Mailing Address - Phone:650-422-1975
Mailing Address - Fax:
Practice Address - Street 1:2049 GRANT RD
Practice Address - Street 2:
Practice Address - City:LOS ALTOS
Practice Address - State:CA
Practice Address - Zip Code:94024-6913
Practice Address - Country:US
Practice Address - Phone:650-422-1975
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-25
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach