Mr Emilio Licea Iii, PSYD in Sebastopol, CA

Mr Emilio Licea Iii, PSYD is a medicare enrolled "Psychologist - Clinical" provider in Sebastopol, California. His current practice location is 652 Petaluma Ave, Sebastopol, California. You can reach out to his office (for appointments etc.) via phone at (707) 823-3166.

Mr Emilio Licea Iii is licensed to practice in California (license number PSY29447) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1336496710.

Contact Information

	Mr Emilio Licea Iii, PSYD
	652 Petaluma Ave, Sebastopol, CA 95472-4256
	(707) 823-3166
	(707) 869-8170

Map and Direction

Healthcare Provider's Profile

Full Name	Mr Emilio Licea Iii
Gender	Male
Speciality
Experience	Years
Location	652 Petaluma Ave, Sebastopol, California
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Mr Emilio Licea Iii attended and graduated from in

NPI Data:

NPI Number: 1336496710
Provider Enumeration Date: 08/05/2012
Last Update Date: 12/30/2021

Medicare PECOS Information:

PECOS PAC ID:
Enrollment ID:

Medical Identifiers

Medical identifiers for Mr Emilio Licea Iii such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1336496710	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103TC0700X	Psychologist - Clinical	PSY29447 (California)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Emilio Licea Iii is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mr Emilio Licea Iii, PSYD Po Box 1449, Guerneville, CA 95446-1449 Ph: (707) 869-5977	Mr Emilio Licea Iii, PSYD 652 Petaluma Ave, Sebastopol, CA 95472-4256 Ph: (707) 823-3166

Reviews and Comments

Psychologist in Sebastopol, CA

Dr. Diana Louise Trichilo, PH.D., ABPDN Psychologist Medicare: Medicare Enrolled Practice Location: 450 Pitt Ave, Suite 3, Sebastopol, CA 95472 Phone: 707-824-1130
Dr. Richard Giovannoli, PHD Psychologist Medicare: Accepting Medicare Assignments Practice Location: 874 Gravenstein Highway South, Suite 12, Sebastopol, CA 95472 Phone: 707-824-8834 Fax: 707-922-0294
Roberta Latefa Mineo, PHD Psychologist Medicare: Accepting Medicare Assignments Practice Location: 3291 Sullivan Rd, Sebastopol, CA 95472 Phone: 707-953-1139
Dr. Kenneth Hunter Crittenden, PH.D. Psychologist Medicare: Medicare Enrolled Practice Location: 501 Swain Ave, Sebastopol, CA 95472 Phone: 707-823-1122
Anne M Pincus, PHD Psychologist Medicare: Accepting Medicare Assignments Practice Location: 1070 Gravenstein Hwy S., Suite 130, Sebastopol, CA 95472 Phone: 415-431-3331
Dr. William Lenard Schwimmer, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 11250 Barnett Valley Rd, Sebastopol, CA 95472 Phone: 707-829-8566
Dr. Richard P Caruso, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 7470 Kennedy Rd, Sebastopol, CA 95472 Phone: 707-544-1707

Mr Emilio Licea Iii, PSYD - Medicare Psychologist in Sebastopol, CA