Provider Demographics
NPI:1104952324
Name:BARATTA, JOSEPH ANTHONY (DC)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:ANTHONY
Last Name:BARATTA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:15520 ROCKFIELD BLVD
Mailing Address - Street 2:STE A200
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-6705
Mailing Address - Country:US
Mailing Address - Phone:949-598-9999
Mailing Address - Fax:949-598-9990
Practice Address - Street 1:2815 MITCHELL DR
Practice Address - Street 2:#101
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-1623
Practice Address - Country:US
Practice Address - Phone:925-930-9522
Practice Address - Fax:925-930-7104
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2020-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15803111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0158030Medicare UPIN