Notice of Privacy Practices

Provider: Rafael Cazares, LMFT | License: #150588

Effective Date: May 11, 2026

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Our Commitment to Your Privacy

We are required by federal (HIPAA) and California law (CMIA) to maintain the privacy of your Protected Health Information (PHI) and to provide you with this notice detailing our legal duties and privacy practices. We are committed to safeguarding your personal health information and maintaining complete transparency about how your records are managed.

How We Use and Disclose Your PHI

  • Treatment: To provide, coordinate, or manage your mental health care and related services.

  • Payment: To bill and collect payment from you, your health insurance carrier (e.g., via Headway, Aetna, Anthem, Blue Shield), or process out-of-network superbills.

  • Healthcare Operations: To support the administrative, legal, and business activities of the practice (such as clinical quality reviews, practice auditing, and compliance management).

  • AI Documentation: We utilize HIPAA-compliant, secure AI-assisted technology to organize and refine clinical notes. No audio or video recordings are ever captured, saved, or stored by this technology.

  • Substance Use Disorder (SUD) Records: In accordance with federal regulations (42 CFR Part 2 and HIPAA alignment), any records related to substance use disorder assessment, diagnosis, or treatment receive heightened protection. These records will not be disclosed or re-disclosed without your express written consent, except in narrowly defined emergencies or legally mandated court orders.

  • Authorizations Required: Psychotherapy notes (if kept separately from the official medical record), marketing, or the sale of PHI require your explicit written authorization and may be revoked at any time.

  • As Required by Law: We may disclose PHI when required by federal, state, or local laws (e.g., mandatory reporting of child, elder, or dependent adult abuse, court orders, or when disclosure is necessary to prevent a serious and imminent threat to health or safety).

Your Rights Regarding Your PHI

  • Right to Inspect and Copy: You have the right to review and obtain an electronic or physical copy of your mental health record.

  • Right to Request Amendments: You can request that we correct or update your clinical record if you believe information is missing or inaccurate.

  • Right to Restrict Disclosures: You may request restrictions on how your PHI is used or shared. If you pay for a service entirely out-of-pocket, you have the right to restrict disclosures of that specific care to your health insurance plan.

  • Right to Confidential Communications: You have the right to request that we communicate with you in a specific way or at a specific location (for example, via email or a specific phone number).

  • Right to an Accounting of Disclosures: You have the right to request a list of certain non-routine disclosures of your PHI made outside of standard treatment, payment, or operational needs.

  • Right to Breach Notification: You have the right to be notified promptly in the event of an unpermitted access, acquisition, use, or disclosure of your unsecured PHI.

  • Right to a Paper Copy: You have the right to receive a physical paper copy of this notice upon request, even if you agreed to receive it electronically.

Changes to This Notice

We reserve the right to change our privacy practices and the terms of this notice at any time. Revised notices will apply to all PHI we maintain and will be posted on our website and in our secure client portal.

Complaints & Contact Information

If you believe your privacy rights have been violated, or if you have questions about these privacy practices, you may contact:

You will not be penalized or retaliated against in any way for filing a privacy complaint.

Board of Behavioral Sciences Notice

The Board of Behavioral Sciences receives and responds to complaints regarding services provided within the scope of practice of marriage and family therapists. Contact the board at: