DORENE G BLAKE, MA MFT — NPI 1225191745 (Licensed & Credentialed Behavioral Health & Social Service Providers — Marriage and Family Therapist in CAPITOLA, CA)

CMS-1500 Box 24J / 33a • NPI

1225191745

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

106H00000X (CMS E1)

Licensed & Credentialed Behavioral Health & Social Service Providers — Marriage and Family Therapist

Box 32 Service Location & ZIP+4

820 BAY AVENUE, SUITE 132, CAPITOLA, CA, 95010

Official NPPES Practice Location

Practice Phone & Referral Fax

(831) 475-1615

Fax: (831) 476-2433

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1225191745 (DORENE G BLAKE, MA MFT) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1225191745` (NPI-1 Individual Practitioner)
Provider / Legal Name	DORENE G BLAKE, MA MFT
Plain-English Specialty	Licensed & Credentialed Behavioral Health & Social Service Providers — Marriage and Family Therapist NUCC Code: `106H00000X` (Marriage & Family Therapist)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	820 BAY AVENUE, SUITE 132, CAPITOLA, CA, 95010
Practice Telephone / Fax	Tel: (831) 475-1615 \| Fax: (831) 476-2433
Administrative Mailing Address	4160 JADE ST, CAPITOLA, CA, 95010
Enumeration & Last Sync	Enumerated: 2006-12-18 \| CMS Record Updated: 2007-07-08

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

820 BAY AVENUE, SUITE 132, CAPITOLA, CA, 95010

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Plain-English Taxonomy & CMS Crosswalk (106H00000X)

What Does Taxonomy Code 106H00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 106H00000X translates to:
"Licensed & Credentialed Behavioral Health & Social Service Providers — Marriage and Family Therapist"

CMS-1500 Medicare Specialty Crosswalk: CMS Code E1 (Marriage and Family Therapist)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Marriage & Family Therapist for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (DORENE G BLAKE, MA MFT)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`106H00000X` — Marriage & Family Therapist Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Marriage and Family Therapist	State: CA \| License: `MFT27688` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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DORENE G BLAKE, MA MFT (NPI #1225191745)