Healthcare Provider Details

I. General information

NPI: 1275909640
Provider Name (Legal Business Name): ZENA RACHELLE CAPUTO LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2015
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3620 LONG BEACH BLVD STE C7
LONG BEACH CA
90807-6013
US

IV. Provider business mailing address

3620 LONG BEACH BLVD STE C7
LONG BEACH CA
90807-6013
US

V. Phone/Fax

Practice location:
  • Phone: 415-562-8641
  • Fax:
Mailing address:
  • Phone: 415-562-8641
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number110182
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number166.001524
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: