Basic Information
| Provider Information | |||||||||
| NPI: | 1063852242 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LOVE | ||||||||
| FirstName: | DONNA | ||||||||
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| Credential: | MSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 22804 CHARDONNAY DR | ||||||||
| Address2: | UNIT 3 | ||||||||
| City: | DIAMOND BAR | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917654111 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9098606932 | ||||||||
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| Practice Location | |||||||||
| Address1: | 11731 TELEGRAPH RD | ||||||||
| Address2: | SUITE G | ||||||||
| City: | SANTA FE SPRINGS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 906703675 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5629498455 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/02/2013 | ||||||||
| LastUpdateDate: | 09/11/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | ASW62982 | CA | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.