Mr. Emilio Licea Iii

PSYD | Clinical Psychologist | 8+ years Exp


  652 Petaluma Ave, Sebastopol
     California, 95472-4256
  707-823-3166    707-869-8170 Maps & Directions
Mr. Emilio Licea Iii is a Sebastopol, California based psychologist with 8 years of experience in Clinical Psychology. He completed his graduation in 2016. He accepts the Medicare-approved amount. Patients will not be billed for any more than the Medicare deductible and coinsurance. Active license number of Mr. Emilio Licea Iii is PSY29447 for Clinical Psychology in California. His current practice location is 652 Petaluma Ave, Sebastopol. Patients can reach him at 707-823-3166 or can fax him at 707-869-8170. Mr. Emilio Licea Iii is PSYD in Clinical Psychology and his NPI number (Unique professional ID assigned by NPPES) is 1336496710.
Mr. Emilio Licea Iii is a mental health professional with highly specialized training in the diagnosis and psychological treatment of mental, behavioral and emotional illnesses, including obsessive-compulsive disorder (OCD). His main focus is on diagnosing and treating mental, emotional, and behavioral disorders. Some of the common disorders that he can treat are learning disabilities, substance abuse, depression, anxiety, and eating disorders.
Complete Profile:
Mr. Emilio Licea Iii speciality, credentials, practice address, contact phone number and fax are as below. Patients can call on the below given phone number for appointment.
Name: Mr. Emilio Licea Iii
Specialization: Clinical Psychology
Gender:Male
Credentials: PSYD
Experience: 8+ years
Medical School Attended:Other
Graduation Year:2016
Accepts Medicare Assignment:Yes
Practice Address:652 Petaluma Ave, Sebastopol,
California, 95472-4256
Phone:707-823-3166
Fax:707-869-8170
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
PAC ID: 2769893304
Enrollment ID: I20201202003069
NPI Number: 1336496710
NPI Enumeration Date: 05 Aug, 2012
NPI Last Update On: 30 Dec, 2021

Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Mr. Emilio Licea Iii are as mentioned below.
License NumberSpecializationStateStatus
PSY29447Clinical Psychology CaliforniaPrimary
Group Practice:
Group practices are practice of medicine by a group of physicians who share their premises and other resources. Following list states all the group name with which Mr. Emilio Licea Iii is associated with along with the number of members in that group.
Organization Name (Group PAC ID) Members
Permanente Medical Group Inc (8921910225)7522
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address: Mr. Emilio Licea Iii
Po Box 1449,
Guerneville, California
Zip: 95446-1449
Phone Number: 707-869-5977
Fax Number: 707-869-5976
Patients can reach Mr. Emilio Licea Iii at 652 Petaluma Ave, Sebastopol, California or can call to book an appointment on 707-823-3166.
Comments/ Reviews:

*Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 11 November, 2024.