Provider Demographics
NPI:1013429992
Name:PENATE, RICARDO JR (RBT)
Entity Type:Individual
Prefix:
First Name:RICARDO
Middle Name:
Last Name:PENATE
Suffix:JR
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7942 DEER LAKE DR
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-4437
Mailing Address - Country:US
Mailing Address - Phone:916-662-4452
Mailing Address - Fax:
Practice Address - Street 1:1901 ROYAL OAKS DR
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95815-3868
Practice Address - Country:US
Practice Address - Phone:916-923-1789
Practice Address - Fax:916-923-1789
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-31
Last Update Date:2017-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARBT-17-29658103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst