Healthcare Provider Details

I. General information

NPI: 1629956602
Provider Name (Legal Business Name): KIRSTEN RATLIFF
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2025
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 PERKINS WAY
AUBURN CA
95603-5709
US

IV. Provider business mailing address

1608 WADSWORTH CIR
ROSEVILLE CA
95747-4448
US

V. Phone/Fax

Practice location:
  • Phone: 925-575-4887
  • Fax:
Mailing address:
  • Phone: 925-575-4887
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License NumberB103A6AE97
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: