Emilio Licea, PSYD
NPI 1336496710 · Clinical Psychologist · Sebastopol, CA
Enrolled with Medicare as Practitioner - Clinical Psychologist · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Emilio Licea, PSYD is a Clinical Psychologist provider in Sebastopol, CA (NPI 1336496710).
Provider details
- NPI number
- 1336496710
- Entity type
- Individual
- Primary specialty
- Clinical PsychologistBehavioral Health & Social Service Providers
- Credential
- PSYD
- Sex
- Male
- Sole proprietor
- No
- License
- PSY29447 (CA)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
13 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2012-08-05
- Last updated
- 2021-12-30
Frequently asked questions
- What is Emilio Licea's NPI number?
- Emilio Licea's National Provider Identifier (NPI) is 1336496710, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Emilio Licea's specialty?
- Emilio Licea is listed in the NPPES registry with a primary specialty of Clinical Psychologist (Behavioral Health & Social Service Providers).
- Where is Emilio Licea located?
- Emilio Licea's practice location on file with NPPES is 652 Petaluma Ave, Sebastopol, CA 95472-4256.
- What is Emilio Licea's phone number?
- The practice phone number listed in the NPPES registry for Emilio Licea is (707) 823-3166.
- Does Emilio Licea accept Medicare?
- Emilio Licea is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Emilio Licea's NPI active?
- Yes — Emilio Licea's NPI (1336496710) is active in the NPPES registry as of the last update on 2021-12-30.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.