Healthcare Provider Details

I. General information

NPI: 1003975236
Provider Name (Legal Business Name): LOVAAS INSTITUTE FOR EARLY INTERVENTION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 11/12/2025
Certification Date: 11/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5601 W SLAUSON AVE STE 168
CULVER CITY CA
90230-6584
US

IV. Provider business mailing address

5601 W SLAUSON AVE STE 168
CULVER CITY CA
90230-6584
US

V. Phone/Fax

Practice location:
  • Phone: 310-410-4450
  • Fax: 310-410-4455
Mailing address:
  • Phone: 310-410-4450
  • Fax: 310-410-4455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-00-0252
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number23924
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number4520
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MATTHEW S. SANDS
Title or Position: CFO
Credential:
Phone: 610-564-0912