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1497162119
INGRID VICENCIO
RIVERSIDE, CA
NPI
1497162119
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: CA LCSW113871)
Enumeration Date
2014-07-14
Last Update Date
2025-01-13
Business Address
INGRID VICENCIO
4164 BROCKTON AVE
RIVERSIDE, CA 92501-3400
Phone number: 951-683-5193
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Mailing Address
INGRID VICENCIO
4164 BROCKTON AVE
RIVERSIDE, CA 92501-3400
Phone number: 951-683-5193
Copy
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