Healthcare Provider Details

I. General information

NPI: 1588239925
Provider Name (Legal Business Name): HELEN DAWN RICCOBONO M.A., LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2021
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 DUSTY TRL
TRABUCO CANYON CA
92679-5344
US

IV. Provider business mailing address

28081 MARGUERITE PKWY
MISSION VIEJO CA
92690-1800
US

V. Phone/Fax

Practice location:
  • Phone: 949-742-4627
  • Fax:
Mailing address:
  • Phone: 949-742-4627
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number146593
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: