Provider Demographics
NPI:1689024390
Name:VILLATORO, ERIKA SARAI (RBT)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:SARAI
Last Name:VILLATORO
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26000 SW 144TH AVE RD APT 115
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-7414
Mailing Address - Country:US
Mailing Address - Phone:786-214-2514
Mailing Address - Fax:
Practice Address - Street 1:26000 SW 144TH AVE RD APT 115
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33032-7414
Practice Address - Country:US
Practice Address - Phone:786-214-2514
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-14
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RBT-15-09020106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL017866500Medicaid
RBT-15-09020OtherBEHAVIOR ANALYST CERTIFICATION BOARD