MEDICARE: DR. MARIE ALVIK LOVDOKKEN PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	172V00000X	Community Health Worker
2	390200000X	Student in an Organized Health Care Education/Training Program
3	103T00000X	Psychologist	PSY29253	CA

General Provider Information

NPI Number	:	1942442033
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIE ALVIK LOVDOKKEN PH.D.

Provider Business Mailing Address
First Line	:	3746 FOOTHILL BLVD # 7049
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91214-1740
Country	:	US
Telephone Number	:	818-275-2517
Fax Number	:

Provider Business Practice Location Address
First Line	:	3746 FOOTHILL BLVD # 7049
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91214-1740
Country	:	US
Telephone Number	:	818-275-2517
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/03/2009
Last Update Date	:	09/07/2022

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