PETER ROSS RATKOVICH (NPI# 1063986529) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1063986529 |
Entity Type | Individual |
Full Name | PETER ROSS RATKOVICH |
Credential | CADC-CAS |
Practice Address |
4104 Delta St San Diego CA 92113-4113 |
Practice Telephone | 6192640141 |
Practice Fax Number | 6192647274 |
Mailing Telephone | 6192640141 |
Mailing Fax Number | 6192647274 |
Enumeration Date | 2019-01-17 |
Last Update Date | 2019-01-17 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
370012AN | CA | Behavioral Health & Social Service Providers |
Street Address |
4104 DELTA ST |
City | SAN DIEGO |
State | CA |
Zip Code | 92113-4113 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013031541 | Traditin One, Inc | Substance Abuse Rehabilitation Facility | 4104 Delta St, San Diego, CA 92113-4113 | 2007-03-19 |
1740829233 | James Richard Gamble Sr. | Counselor | 4104 Delta St, San Diego, CA 92113-4113 | 2019-12-31 |
1376184408 | Patrick Wallace | Counselor | 4104 Delta St, San Diego, CA 92113-4113 | 2019-09-30 |
1538719174 | Delores Von Mirbach | Counselor | 4104 Delta St, San Diego, CA 92113-4113 | 2019-09-16 |
1255985917 | Ralph Anthony Ramirez | Counselor | 4104 Delta St, San Diego, CA 92113-4113 | 2019-07-30 |
1083173629 | Melissa Bouchard | Peer Specialist | 4104 Delta St, San Diego, CA 92113-4113 | 2019-03-13 |
1134683337 | Cassandra Elizabeth Arnold | Counselor | 4104 Delta St, San Diego, CA 92113-4113 | 2019-01-22 |
1679037873 | Albert Lee Cherry Jr. | Counselor | 4104 Delta St, San Diego, CA 92113-4113 | 2019-01-22 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1609305986 | Cynthia Alba | Nutritionist | 1809 National Ave., San Diego, CA 92113 | 2017-06-08 |
1184153983 | Jessy Milligan | Counselor | 4125 Alpha Street, San Diego, CA 92113 | 2017-06-06 |
1730557406 | Deborah Mary Malloy | Counselor | Jary Barreto, 2865 Logan Avenue, San Diego, CA 92113 | 2015-09-10 |
1104220912 | Imhotep Mustaqeem | Counselor | 3336 Steel Street, San Diego, CA 92113 | 2014-10-22 |
1831507300 | Olga Vasileva | Student in an Organized Health Care Education/Training Program | 2865 Logan Avenue, San Diego, CA 92113 | 2014-07-29 |
1477961951 | Angelica Quezada | Counselor | 32510 Newton Avenue B103, San Diego, CA 92113 | 2014-07-28 |
1477986750 | Anita Pena | Licensed Vocational Nurse | 604 Olivewood Ter, San Diego, CA 92113 | 2013-08-09 |
1134459399 | Susana Cabada | Technician, Other | 4031 Marine View Ave., San Diego, CA 92113 | 2010-01-11 |
1669595609 | Maria Emilia Siller | Registered Nurse | 3177a Oceanview Blvd, San Diego, AL 92113 | 2007-04-06 |
1710009691 | Maria Engracia Siordia | Licensed Vocational Nurse | 3177a Ocean View Blvd, San Diego, CA 92113 | 2007-04-04 |
Find all providers in zip 92113 |
Taxonomy Code | 101YA0400X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Counselor |
Specialization | Addiction (Substance Use Disorder) |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1053910901 | Eduardo Alberto Perez | Counselor | 8829 Dewsbury Ave, San Diego, CA 92126-2428 | 2020-10-21 |
1477166734 | Laura Aida Andrade | Counselor | 4125 Wabash Ave, San Diego, CA 92104-2124 | 2020-08-26 |
1679113096 | David Salvador Avalos | Counselor | 3642 Rosa Linda St, San Diego, CA 92154-3653 | 2020-01-14 |
1023651692 | Robert Joseph Kassel | Counselor | 6551 Seaman St, San Diego, CA 92120-2629 | 2019-10-25 |
1609437979 | Pamela Lynette Hill | Counselor | 3960 W Point Loma Blvd, San Diego, CA 92110-5643 | 2019-06-26 |
1154989838 | Victoria Philips | Counselor | 4055 58th St Apt 10, San Diego, CA 92115-6209 | 2019-05-29 |
1740847375 | Jessica Cristina Williams | Counselor | 1775 Elm Ave, San Diego, CA 92154-1104 | 2019-05-20 |
1659934164 | Virginia Denise Mcswain | Counselor | 220 Euclid Ave Ste 200, San Diego, CA 92114-3644 | 2019-04-19 |
1386107324 | Connie Padera | Counselor | 3148 Midway Dr # 113, San Diego, CA 92110-4539 | 2019-04-08 |
1154891067 | Vincent Garside | Counselor | 2516 A Sreet, San Diego, CA 92102-9210 | 2018-12-04 |
Find all providers in SAN DIEGO |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.