Provider Demographics
NPI:1346307972
Name:ZICCARDI, CHRISTINE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:
Last Name:ZICCARDI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2008 MORSE AVE
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-2135
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:132 E ST
Practice Address - Street 2:SUITE 310
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616-4649
Practice Address - Country:US
Practice Address - Phone:530-204-8072
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA190571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical