Provider Demographics
NPI:1992245872
Name:CEPEDA, RAY (BCBA)
Entity type:Individual
Prefix:
First Name:RAY
Middle Name:
Last Name:CEPEDA
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 BROAD ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-2009
Mailing Address - Country:US
Mailing Address - Phone:973-294-8819
Mailing Address - Fax:
Practice Address - Street 1:22 PARSONAGE ST STE 147
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-4732
Practice Address - Country:US
Practice Address - Phone:973-294-8819
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-27
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst