Provider Demographics
NPI:1154527216
Name:SAUQUE, RICARDO JOSEPH (MFT)
Entity type:Individual
Prefix:
First Name:RICARDO
Middle Name:JOSEPH
Last Name:SAUQUE
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 414
Mailing Address - Street 2:
Mailing Address - City:HAUULA
Mailing Address - State:HI
Mailing Address - Zip Code:96717-0414
Mailing Address - Country:US
Mailing Address - Phone:808-203-8113
Mailing Address - Fax:
Practice Address - Street 1:54-182 HANAIMOA ST
Practice Address - Street 2:
Practice Address - City:HAUULA
Practice Address - State:HI
Practice Address - Zip Code:96717-9615
Practice Address - Country:US
Practice Address - Phone:808-203-8113
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist