Individual provider Active NPI

Alicia Rose Audino, LMFT

  • Marriage & Family Therapist
  • Folsom, CA
National Provider Identifier
1063995587
Registry record updated Mar 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT143194 Issued in CA
Practice address
2365 Iron Point Rd Ste 210
Folsom, CA 95630-8713
Phone
(925) 282-1778
Fax
(415) 296-5299
NPI assigned
Sep 11, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LMFT143194 CA Primary

Addresses

Primary practice location

2365 Iron Point Rd Ste 210
Folsom, CA 95630-8713

Mailing address

2365 Iron Point Rd Ste 210
Folsom, CA 95630-8713
Phone (925) 282-1778

Other practice location 1

1624 Santa Clara Dr Ste 145
Roseville, CA 95661-3500
Phone (916) 779-2455

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250410003042 CA Practitioner - Marriage and Family Therapist 2769906791 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4800 N Scottsdale Rd
Suite 2500
Scottsdale, AZ 85251-7630

490 Post St
San Francisco, CA 94102-1301

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMFT143194CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Coast Psychiatric Associates Inc CurrentSince Mar 1, 2025 Accepting new patients
Pacific Clinics PastSince Jul 10, 2022 Accepting new patients

Locations

1480 64th St
Ste 150
Emeryville, CA 94608
Phone (415) 296-5292

2365 Iron Point Rd
Ste 210
Folsom, CA 95630
Phone (925) 360-5264

490 Post St
Ste 1043
San Francisco, CA 94102
Phone (415) 409-0944

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1536624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741046400000",
    "number": "1063995587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2365 IRON POINT RD STE 210",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956308713",
            "telephone_number": "925-282-1778",
            "fax_number": "415-296-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2365 IRON POINT RD STE 210",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956308713",
            "telephone_number": "925-282-1778",
            "fax_number": "415-296-5299"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1624 Santa Clara Dr Ste 145",
            "address_purpose": "LOCATION",
            "city": "Roseville",
            "state": "CA",
            "postal_code": "956613500",
            "country_code": "US",
            "telephone_number": "916-779-2455",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AUDINO",
        "first_name": "ALICIA",
        "middle_name": "ROSE",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-11",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT143194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Folsom, CA

Sources for this page

Verify at the official NPI Registry.