Provider Demographics
NPI:1801910138
Name:RATTI, JYOTHI (MD)
Entity type:Individual
Prefix:
First Name:JYOTHI
Middle Name:
Last Name:RATTI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5565 W LAS POSITAS BLVD
Mailing Address - Street 2:SUITE 260
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-4001
Mailing Address - Country:US
Mailing Address - Phone:925-416-5470
Mailing Address - Fax:
Practice Address - Street 1:5565 W LAS POSITAS BLVD
Practice Address - Street 2:SUITE 260
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-4001
Practice Address - Country:US
Practice Address - Phone:925-416-5470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVLL1663390200000X
CAA106802207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP00779830OtherRAILROAD MEDICARE
CA1801910138Medicaid
CA1801910138Medicaid
CA1801910138Medicaid