Provider Demographics
NPI:1730461336
Name:RONDON, BLANCA LETICIA (LCSW)
Entity Type:Individual
Prefix:
First Name:BLANCA
Middle Name:LETICIA
Last Name:RONDON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1129 MEADOW CREEK CT
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:TX
Mailing Address - Zip Code:75146-1320
Mailing Address - Country:US
Mailing Address - Phone:951-500-6404
Mailing Address - Fax:
Practice Address - Street 1:1129 MEADOW CREEK CT
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:TX
Practice Address - Zip Code:75146-1320
Practice Address - Country:US
Practice Address - Phone:951-500-6404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-09
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1051821041C0700X
CA737711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical