Provider Demographics
NPI:1851673446
Name:WEINSTEIN, RICARDO (PHD)
Entity Type:Individual
Prefix:DR
First Name:RICARDO
Middle Name:
Last Name:WEINSTEIN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171 SAXONY RD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-6775
Mailing Address - Country:US
Mailing Address - Phone:760-753-1890
Mailing Address - Fax:760-942-4004
Practice Address - Street 1:171 SAXONY RD
Practice Address - Street 2:SUITE 108
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-6775
Practice Address - Country:US
Practice Address - Phone:760-753-1890
Practice Address - Fax:760-942-4004
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-09
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY8954103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist