Provider Demographics
NPI:1932495892
Name:LUCIO, ALICIA MONICA (LMFT)
Entity Type:Individual
Prefix:MS
First Name:ALICIA
Middle Name:MONICA
Last Name:LUCIO
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 1:920 CALLE DEL CIELO
Mailing Address - Street 2:
Mailing Address - City:BRAWLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92227-7715
Mailing Address - Country:US
Mailing Address - Phone:760-587-8914
Mailing Address - Fax:
Practice Address - Street 1:920 CALLE DEL CIELO
Practice Address - Street 2:
Practice Address - City:BRAWLEY
Practice Address - State:CA
Practice Address - Zip Code:92227-7715
Practice Address - Country:US
Practice Address - Phone:760-587-8914
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-20
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF 67042106H00000X
CA114973106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist