Ricardo De la Pena, RBT

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

5336 Issued in TX

Practice address

7631 Ponderosa Pne
Boerne, TX 78015-5141

Phone

(956) 266-1205

Fax

(210) 941-0723

NPI assigned

Apr 30, 2019

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Polestar ABA Therapy LLC

  • Behavior Analyst
  • Houston, TX
  • NPI 1942926522
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1556582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702944000000",
    "number": "1497319925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7631 PONDEROSA PNE",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780155141",
            "telephone_number": "956-266-1205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7631 PONDEROSA PNE",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780155141",
            "telephone_number": "956-266-1205",
            "fax_number": "210-941-0723"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1020 Central Pkwy S # 1020",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782325021",
            "country_code": "US",
            "telephone_number": "210-798-2273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE LA PENA",
        "first_name": "RICARDO",
        "name_prefix": "Mr.",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-30",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "TX",
            "license": "RBT-16-15938",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "TX",
            "license": "5336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Davis
• Eric Randell Day, A.T.C., L.A.T.
• Morgan Lee Day
• Giancarlo De Jesus, PT
• Avery Kristie De la Pena, MSOT, OTR
• Jesenia Christiann De Leon
• Melanie Vela De Leon, PHARMD
• Karen Becker Deanda, PHARMD
• David Edgar Deas, DMD, MS
• Decision Height, Inc

• Behavior Analyst in Boerne, TX
• Providers in Boerne, TX by specialty
• Behavior Analyst in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.