Healthcare Provider Details

I. General information

NPI: 1730650102
Provider Name (Legal Business Name): BARBARA LOVING
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2018
Last Update Date: 12/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1904 RICHLAND AVE BLDG A
CERES CA
95307-4562
US

IV. Provider business mailing address

1313 CELESTE DR
MODESTO CA
95355-2433
US

V. Phone/Fax

Practice location:
  • Phone: 209-300-8800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number696951
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: