Provider Demographics
NPI:1689423212
Name:SICAIROS, ROSA (LPCC, LMFT)
Entity type:Individual
Prefix:
First Name:ROSA
Middle Name:
Last Name:SICAIROS
Suffix:
Gender:F
Credentials:LPCC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6771 WARNER AVE UNIT 1402
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-9417
Mailing Address - Country:US
Mailing Address - Phone:714-458-2443
Mailing Address - Fax:
Practice Address - Street 1:6771 WARNER AVE UNIT 1402
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-9417
Practice Address - Country:US
Practice Address - Phone:714-458-2443
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-15
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16141101YP2500X
CA149958106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional