Healthcare Provider Details

I. General information

NPI: 1538078423
Provider Name (Legal Business Name): SELF LOVE INTEGRATIVE PSYCHOLOGY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17762 COWAN STE 100
IRVINE CA
92614-6035
US

IV. Provider business mailing address

4590 MACARTHUR BLVD STE 500
NEWPORT BEACH CA
92660-2028
US

V. Phone/Fax

Practice location:
  • Phone: 949-342-5053
  • Fax: 949-266-5619
Mailing address:
  • Phone: 949-342-5053
  • Fax: 949-266-5619

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. HESSAM MOTAMEDIAN
Title or Position: DIRECTOR
Credential: PSYD
Phone: 949-342-5053