Individual provider · Type 1 NPI

Emilio Licea Iii, PSYD

Clinical Psychologist · Sebastopol, CA

NPI number 1336496710 Active

Practice location

652 Petaluma Ave
Sebastopol, CA 95472-4256

Call (707) 823-3166 Map

Fax (707) 869-8170

Mailing address

PO Box 1449
Guerneville, CA 95446-1449

Specialties and licenses

TaxonomyCodeLicense
Clinical Psychologist Primary 103TC0700XPSY29447 (CA)

Clinical Psychologist: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of discip…

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About NPI 1336496710

Emilio Licea Iii, PSYD's National Provider Identifier is 1336496710, issued on Aug 5, 2012. The primary taxonomy on file is Clinical Psychologist (103TC0700X), and the practice location is in Sebastopol, CA. The record was last updated on Dec 30, 2021.