EMILIO LICEA

SEBASTOPOL, CA
NPI1336496710
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy103TC0700X Psychologist Clinical
(Licence: CA  PSY29447)
Enumeration Date2012-08-05
Last Update Date2021-12-30
Business Address
MR. EMILIO LICEA PSYD
652 PETALUMA AVE
SEBASTOPOL, CA 95472-4256
Phone number: 707-823-3166
Mailing Address
MR. EMILIO LICEA PSYD
PO BOX 1449
GUERNEVILLE, CA 95446-1449
Phone number: 707-869-5977
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