Provider Demographics
NPI:1598302887
Name:BOCANEGRA, KARINA LISETTE (MA, LMFT)
Entity Type:Individual
Prefix:MS
First Name:KARINA
Middle Name:LISETTE
Last Name:BOCANEGRA
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6363 DE ZAVALA RD STE 300
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249-2104
Mailing Address - Country:US
Mailing Address - Phone:210-399-4838
Mailing Address - Fax:
Practice Address - Street 1:6363 DE ZAVALA RD STE 300
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249-2104
Practice Address - Country:US
Practice Address - Phone:210-399-4838
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-05
Last Update Date:2019-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX203047106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist