Provider Demographics
NPI:1275909640
Name:CAPUTO, ZENA RACHELLE (LMFT)
Entity Type:Individual
Prefix:
First Name:ZENA
Middle Name:RACHELLE
Last Name:CAPUTO
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:454 LAS GALLINAS AVE # 3029
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94903-3618
Mailing Address - Country:US
Mailing Address - Phone:415-238-3367
Mailing Address - Fax:
Practice Address - Street 1:401 W ONTARIO ST STE 150
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60654-6750
Practice Address - Country:US
Practice Address - Phone:415-238-3367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-19
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL166.001524106H00000X
CA110182106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist