Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | PSY7112 | CA |
NPI | 1558489591 |
---|---|
Provider Name | Dr. Joseph Henry Bratsky |
First Address | La Jolla, CA 92037-1807 |
Second Address | La Jolla, CA 92037-1807 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2007 |
Last Update Date | 10/08/2012 |