Brian Licuanan, PHD
NPI 1508241779ActiveIndividual· Psychologist, Counseling· Irvine, CA
Psychologist, Counseling (PHD) with Telemedicine Group PC and 1 other group, practicing in Irvine, California. Enrolled in Medicare as practitioner - clinical psychologist.
Overview
| NPI | 1508241779 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PHD |
| Sole proprietor | Yes |
| NPI issued | Jul 29, 2015 |
| Last updated in NPPES | Jul 29, 2015 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist, Counseling Primary | 103TC1900X | 27276 | CA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Psychologist (CA) |
|---|
Education and affiliations
| Graduation year | 2010 |
|---|---|
| Medicare specialty | Clinical Psychologist |
Medical groups
- Telemedicine Group PCRoseville, CA · 100 clinicians
- John C Fremont Healthcare DistrictMariposa, CA · 18 clinicians
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