Basic Information
Provider Information
NPI: 1720573843
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TATTI
FirstName: JAMES
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: OTR/L
OtherOrganizationName:  
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OtherCredential:  
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Mailing Information
Address1: 4378 MONHEGAN WAY
Address2:  
City: MATHER
State: CA
PostalCode: 956553042
CountryCode: US
TelephoneNumber: 7072357291
FaxNumber:  
Practice Location
Address1: 585 NUT TREE CT
Address2:  
City: VACAVILLE
State: CA
PostalCode: 956873353
CountryCode: US
TelephoneNumber: 7074498000
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/30/2018
LastUpdateDate: 06/30/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000X19371FLN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 
225X00000X18559CAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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