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Mr. Emilio Licea III, PSYD
Clinical Psychologist in Sebastopol, California
NPI 1336496710

Emilio Licea III is a Clinical Psychologist based in Guerneville, CA and is specialized in Clinical. Emilio Licea III practices in Sebastopol, CA and has the professional credentials of PSYD. The NPI Number for Emilio Licea III is 1336496710 and holds a License No. PSY29447 (California).

The current practice location address for Emilio Licea III is 652 Petaluma Ave, Sebastopol, CA and can be reached out via phone at 707-823-3166 and via fax at 707-869-8170.

Location: 652 Petaluma Ave, Sebastopol, CA, 95446-1449
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1336496710
Provider Name
Emilio Licea III
Credential
PSYD
Provider Entity Type
Individual
Gender
Male
Address
652 Petaluma Ave, Sebastopol, CA, 95446-1449
Phone Number
707-823-3166
Fax Number
707-869-8170
Provider Enumeration Date
08/05/2012
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
652 Petaluma Ave
City
Sebastopol
State
California
Zip
95472-4256
Phone Number
707-823-3166
Fax Number
707-869-8170
person
Provider Business Mailing Address Details
Address
652 Petaluma Ave
City
Sebastopol
State
California
Zip
95472-4256
Phone Number
707-823-3166
Fax Number
707-869-8170
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Psychologist
Speciality
Clinical
Taxonomy
103TC0700X
License No.
PSY29447 (California)
Definition
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 disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
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