Blanca Estela Pena

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

138765 Issued in CA

Practice address

516 Cypress St
Fort Bragg, CA 95437-5410

Phone

(415) 583-7564

NPI assigned

Nov 1, 2017

Last updated

Nov 12, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Redwood Community Services, Inc.

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Ukiah, CA
  • NPI 1285187526
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1509494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1801308747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 S ORCHARD AVE APT 4",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954827448",
            "telephone_number": "415-583-7564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 CYPRESS ST",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "954375410",
            "telephone_number": "415-583-7564"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "681 Leslie St",
            "address_purpose": "LOCATION",
            "city": "Ukiah",
            "state": "CA",
            "postal_code": "954825500",
            "country_code": "US",
            "telephone_number": "707-813-2159",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENA",
        "first_name": "BLANCA",
        "middle_name": "ESTELA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-01",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CA",
            "license": "114429",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "138765",
            "primary": true
        },
        {
            "code": "225C00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor",
            "state": "CA",
            "license": "114429",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "CA",
            "license": "114429",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bethany Ann Parsen, RN
• Tammy Gail Patrick
• Joanne Louise Patterson, FNP
• Erin Paul
• David L Pellandini, HAD
• Joeann Perdue
• Monalisa Perez, RPT
• Catherine Anne Perkins, CARE MANAGER 11
• Linda Ann Perry, LMFT
• Sabrina M Peterson, CERT. DOULA, C.M.T,

• Marriage & Family Therapist in Fort Bragg, CA
• Providers in Fort Bragg, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.