Provider Demographics
NPI:1932533213
Name:MARENCO, ALICIA RODRIGUEZ (LCSW)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:RODRIGUEZ
Last Name:MARENCO
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 1:3857 BIRCH ST STE 605
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-2616
Mailing Address - Country:US
Mailing Address - Phone:909-762-1684
Mailing Address - Fax:
Practice Address - Street 1:12830 HESPERIA RD STE CD&E
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-7788
Practice Address - Country:US
Practice Address - Phone:909-762-1684
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-22
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health