Provider Demographics
NPI:1326360025
Name:ASCENCIO, ALCIRA (LMFT)
Entity Type:Individual
Prefix:
First Name:ALCIRA
Middle Name:
Last Name:ASCENCIO
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 1:3336 BRADSHAW RD STE 175
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827-2631
Mailing Address - Country:US
Mailing Address - Phone:916-403-0588
Mailing Address - Fax:
Practice Address - Street 1:3336 BRADSHAW RD STE 175
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95827-2631
Practice Address - Country:US
Practice Address - Phone:916-403-0588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-22
Last Update Date:2018-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT 83804106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA83804OtherBOARD OF BEHAVIORAL SCIENCES