Provider Demographics
NPI:1033504493
Name:MORENO, RONALD FRANCIS GARGARITA (MA, BCBA)
Entity Type:Individual
Prefix:
First Name:RONALD FRANCIS
Middle Name:GARGARITA
Last Name:MORENO
Suffix:
Gender:M
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4688 ONTARIO PKWY
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91764
Mailing Address - Country:US
Mailing Address - Phone:714-487-2642
Mailing Address - Fax:909-476-1236
Practice Address - Street 1:4688 ONTARIO PKWY
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91764
Practice Address - Country:US
Practice Address - Phone:714-487-2642
Practice Address - Fax:909-476-1236
Is Sole Proprietor?:No
Enumeration Date:2015-04-02
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-12-12591103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst