Provider Demographics
NPI:1073112769
Name:COX, ALICIA DIANE (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:DIANE
Last Name:COX
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3941 PARK DR STE 20
Mailing Address - Street 2:
Mailing Address - City:EL DORADO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:95762-4577
Mailing Address - Country:US
Mailing Address - Phone:916-715-6826
Mailing Address - Fax:
Practice Address - Street 1:850 IRON POINT RD
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-9009
Practice Address - Country:US
Practice Address - Phone:916-586-0062
Practice Address - Fax:916-542-2835
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-22
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA121505106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist