Provider Demographics
NPI:1902355308
Name:RITARI, PAIGE MARIE (BCBA)
Entity Type:Individual
Prefix:MISS
First Name:PAIGE
Middle Name:MARIE
Last Name:RITARI
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 AVENIDA DE AMIGOS
Mailing Address - Street 2:
Mailing Address - City:NIPOMO
Mailing Address - State:CA
Mailing Address - Zip Code:93444-9675
Mailing Address - Country:US
Mailing Address - Phone:703-474-1902
Mailing Address - Fax:
Practice Address - Street 1:220 E CLARK AVE
Practice Address - Street 2:SUITE D
Practice Address - City:ORCUTT
Practice Address - State:CA
Practice Address - Zip Code:93455-5339
Practice Address - Country:US
Practice Address - Phone:805-332-3742
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-26
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-16-23515103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst