Provider Demographics
NPI:1013032937
Name:APARICIO, IRENE ALICE (MS, LCSW)
Entity Type:Individual
Prefix:MS
First Name:IRENE
Middle Name:ALICE
Last Name:APARICIO
Suffix:
Gender:F
Credentials:MS, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 RALL AVE
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93612-4493
Mailing Address - Country:US
Mailing Address - Phone:559-291-4966
Mailing Address - Fax:
Practice Address - Street 1:2109 W BULLARD AVE
Practice Address - Street 2:SUITE 145
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-1258
Practice Address - Country:US
Practice Address - Phone:559-439-1534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS204291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical