Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. EMILIO LICEA III, PSYD
ActiveMR. EMILIO LICEA III, PSYD is a Clinical Psychologist healthcare provider located in SEBASTOPOL, California. NPI 1336496710 is currently active in the NPPES registry. Verify at CMS.
Clinical Psychologist · SEBASTOPOL, CA
Registration Details
- NPI Number
- 1336496710
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 5, 2012 (14.020415463255 yrs)
- Last Updated
- Dec 30, 2021
- License
-
PSY29447 (CA)
Practice Information
- Address
-
652 PETALUMA AVESEBASTOPOL, CA, 954724256Browse CA providers · Browse ZIP 95472
- Phone
- 7078233166
- Fax
- 7078698170
- Primary Specialty
-
Clinical Psychologist
103TC0700X
Other Clinical Psychologist Providers in SEBASTOPOL, CA
| Name | Credential | NPI |
|---|---|---|
| DR. JULIET W. DANTIN | PH.D. | 1952332157 |
| DR. ANNELLA TIGARD DALRYMPLE | PH.D. | 1316057540 |
| DR. BRUCE GERARD HINER | PSY.D. | 1922119809 |
| DR. JUNE ANN GORDON | PHD | 1518053578 |
| ZOE BRADLEY-BENOIT | PSY.D. | 1366512360 |
| ANNE M PINCUS | PHD | 1043384720 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.