Individual ProviderRicardo EvaristoBehavior TechnicianBehavioral Health & Social Service ProvidersPractice Address24081 Sandy Glade Ave, Moreno Valley, CA 92557-5529(714) 363-8842PECOS EnrollmentBased on the most recent information from CMS, provider Ricardo Evaristo does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1558860353Provider TypeIndividualFull NameEvaristo, RicardoGenderMaleSole ProprietorNoEnumeration Date2/7/2018Last Updated11/9/2021Contact InformationPractice LocationPractice Address24081 Sandy Glade Ave, Moreno Valley, CA 92557-5529Phone(714) 363-8842FaxUnlisted FaxMailing LocationMailing Address24081 Sandy Glade Ave, Moreno Valley, CA 92557-5529PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode106S00000XPrimaryDescriptionBehavior TechnicianBehavioral Health & Social Service ProvidersLicenseRBT-18-49234CaliforniaCode106S00000XDescriptionBehavior TechnicianBehavioral Health & Social Service ProvidersLicenseUnlisted IssuerCalifornia