| Brian Licorish Psychiatry Llc | |
|
5201 Great America Pkwy Ste 320 Santa Clara CA 95054-1140 | |
| (408) 384-3758 | |
| Not Available |
| Full Name | Brian Licorish Psychiatry Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 5201 Great America Pkwy Ste 320, Santa Clara, California |
| Authorized Official Name and Position | Kenrick Brian Licorish (PSYCHIATRIST) |
| Authorized Official Contact | 9492440104 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brian Licorish Psychiatry Llc 2108 N St Ste N Sacramento CA 95816-5712 Ph: () - | Brian Licorish Psychiatry Llc 5201 Great America Pkwy Ste 320 Santa Clara CA 95054-1140 Ph: (408) 384-3758 |
| NPI Number | 1225759871 |
|---|---|
| Provider Enumeration Date | 09/12/2022 |
| Last Update Date | 07/02/2025 |
| Certification Date | 06/14/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225759871 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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