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

Last updated

Dec 19, 2023By the provider in NPPES

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Polestar ABA Therapy LLC

  dba Path

  • 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 (Medical Center West)

• 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.