Provider Demographics
NPI:1124571005
Name:SAINICK, MARCIA CANEDO (MSW)
Entity Type:Individual
Prefix:MS
First Name:MARCIA
Middle Name:CANEDO
Last Name:SAINICK
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34700 PACIFIC COAST HWY
Mailing Address - Street 2:#104
Mailing Address - City:CAPISTRANO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92624-1351
Mailing Address - Country:US
Mailing Address - Phone:877-682-0043
Mailing Address - Fax:415-795-7537
Practice Address - Street 1:34700 PACIFIC COAST HWY
Practice Address - Street 2:#104
Practice Address - City:CAPISTRANO BEACH
Practice Address - State:CA
Practice Address - Zip Code:92624-1351
Practice Address - Country:US
Practice Address - Phone:877-682-0043
Practice Address - Fax:415-795-7537
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-27
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical