Provider Demographics
NPI:1598199739
Name:GODINA, RICARDO PILAR (MED,, BCBA)
Entity Type:Individual
Prefix:
First Name:RICARDO
Middle Name:PILAR
Last Name:GODINA
Suffix:
Gender:M
Credentials:MED,, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:28245 AVENUE CROCKER STE 220
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-1201
Mailing Address - Country:US
Mailing Address - Phone:661-254-7086
Mailing Address - Fax:661-254-7108
Practice Address - Street 1:28245 AVENUE CROCKER STE 220
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-1201
Practice Address - Country:US
Practice Address - Phone:661-254-7086
Practice Address - Fax:661-254-7108
Is Sole Proprietor?:No
Enumeration Date:2013-08-23
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst