Healthcare Provider Details

I. General information

NPI: 1457008211
Provider Name (Legal Business Name): MICHAEL RATLIFF MSN RN FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2022
Last Update Date: 06/19/2025
Certification Date: 06/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1108 WARD AVE
PATTERSON CA
95363-8529
US

IV. Provider business mailing address

1108 WARD AVE BLDG A STE 1
PATTERSON CA
95363-8529
US

V. Phone/Fax

Practice location:
  • Phone: 209-892-1300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number763477
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95021053
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: