Provider Demographics
NPI:1326443466
Name:RECINOS, BLANCA ALEXIS (LMFT)
Entity Type:Individual
Prefix:MS
First Name:BLANCA
Middle Name:ALEXIS
Last Name:RECINOS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:BLANCA
Other - Middle Name:ALEXIS
Other - Last Name:MONCAYO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:260 MAPLE CT STE 265
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-3572
Mailing Address - Country:US
Mailing Address - Phone:805-625-2244
Mailing Address - Fax:
Practice Address - Street 1:260 MAPLE CT STE 265
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-3572
Practice Address - Country:US
Practice Address - Phone:805-625-2244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-31
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA96672106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist