Provider Demographics
NPI:1386706695
Name:GARRATT, JOHN P (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:P
Last Name:GARRATT
Suffix:
Gender:M
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:PO BOX 231
Mailing Address - Street 2:
Mailing Address - City:COMPTCHE
Mailing Address - State:CA
Mailing Address - Zip Code:95427-0231
Mailing Address - Country:US
Mailing Address - Phone:707-937-4084
Mailing Address - Fax:
Practice Address - Street 1:31300 COMPTCHE-UKIAH RD.
Practice Address - Street 2:
Practice Address - City:COMPTCHE
Practice Address - State:CA
Practice Address - Zip Code:95427-0231
Practice Address - Country:US
Practice Address - Phone:707-937-4084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA242872084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA24287OtherPIN
CA00A242870Medicare ID - Type Unspecified
CAA24287OtherPIN