Provider Demographics
NPI:1184929838
Name:MCCLEOD, ALICIA (LMFT)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:MCCLEOD
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 1:7177 BROCKTON AVE STE 226
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-2633
Mailing Address - Country:US
Mailing Address - Phone:951-394-0165
Mailing Address - Fax:951-788-7075
Practice Address - Street 1:7177 BROCKTON AVE STE 226
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-2633
Practice Address - Country:US
Practice Address - Phone:951-394-0165
Practice Address - Fax:951-788-7075
Is Sole Proprietor?:No
Enumeration Date:2011-01-11
Last Update Date:2020-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95731106H00000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist