Provider Demographics
NPI:1760505671
Name:MAGNO, RONALD DIAL (RON MAGNO, BCBA)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:DIAL
Last Name:MAGNO
Suffix:
Gender:M
Credentials:RON MAGNO, BCBA
Other - Prefix:
Other - First Name:RON
Other - Middle Name:
Other - Last Name:MAGNO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RON MAGNO, BCBA
Mailing Address - Street 1:8119 MARINERS DR
Mailing Address - Street 2:APT #601
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95219-4539
Mailing Address - Country:US
Mailing Address - Phone:209-952-4447
Mailing Address - Fax:
Practice Address - Street 1:548 E PARK ST
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95202-2134
Practice Address - Country:US
Practice Address - Phone:209-464-5519
Practice Address - Fax:209-462-8911
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1-04-1714OtherBOARD CERT BEH ANALYST