Healthcare Provider Details

I. General information

NPI: 1902717432
Provider Name (Legal Business Name): RATI GARYALI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3186 AIRWAY AVE STE A
COSTA MESA CA
92626-4650
US

IV. Provider business mailing address

4390 CAMINITO DEL DIAMANTE
SAN DIEGO CA
92121-1902
US

V. Phone/Fax

Practice location:
  • Phone: 714-881-0427
  • Fax: 714-327-0673
Mailing address:
  • Phone: 424-376-4171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: