Provider Demographics
NPI:1235114885
Name:RICE, MARLENE (MSW)
Entity Type:Individual
Prefix:MS
First Name:MARLENE
Middle Name:
Last Name:RICE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:MARLENE
Other - Middle Name:RICE
Other - Last Name:ICHIKAWA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:718 ALHAMBRA BLVD
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-3825
Mailing Address - Country:US
Mailing Address - Phone:916-441-1925
Mailing Address - Fax:916-441-0367
Practice Address - Street 1:718 ALHAMBRA BLVD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-3825
Practice Address - Country:US
Practice Address - Phone:916-441-1925
Practice Address - Fax:916-441-0367
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-07
Last Update Date:2010-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS68891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ27392ZMedicare ID - Type Unspecified