Healthcare Provider Details

I. General information

NPI: 1932854924
Provider Name (Legal Business Name): SUMARIA LOVE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/17/2022
Last Update Date: 02/17/2022
Certification Date: 02/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5650 MARCONI AVE
CARMICHAEL CA
95608-4462
US

IV. Provider business mailing address

5960 S LAND PARK DR # 415
SACRAMENTO CA
95822-3313
US

V. Phone/Fax

Practice location:
  • Phone: 916-410-8618
  • Fax:
Mailing address:
  • Phone: 916-410-8618
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code224900000X
TaxonomyMastectomy Fitter
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: