Provider Demographics
NPI:1306912852
Name:OGONOWSKI, ALICIA LYNN (LCSW)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:LYNN
Last Name:OGONOWSKI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:LYNN
Other - Last Name:POCHE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 394
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95927
Mailing Address - Country:US
Mailing Address - Phone:530-965-1510
Mailing Address - Fax:
Practice Address - Street 1:500 COHASSET RD
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-2260
Practice Address - Country:US
Practice Address - Phone:530-965-1510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2019-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA273741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical