Provider Demographics
NPI:1962696120
Name:FIRCH, VICKIE MALICA (MA)
Entity type:Individual
Prefix:MRS
First Name:VICKIE
Middle Name:MALICA
Last Name:FIRCH
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:VICKIE
Other - Middle Name:MALICA
Other - Last Name:TREMBLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:7001A EAST PKWY
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-2501
Mailing Address - Country:US
Mailing Address - Phone:916-875-4467
Mailing Address - Fax:916-875-3187
Practice Address - Street 1:3331 POWER INN RD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95826-3889
Practice Address - Country:US
Practice Address - Phone:916-875-4467
Practice Address - Fax:916-875-3187
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-30
Last Update Date:2007-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator