Healthcare Provider Details

I. General information

NPI: 1467386326
Provider Name (Legal Business Name): THE LOVE PRACTICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 PINE AVE STE 403
LONG BEACH CA
90813-4321
US

IV. Provider business mailing address

701 PINE AVE STE 403
LONG BEACH CA
90813-4321
US

V. Phone/Fax

Practice location:
  • Phone: 562-673-8959
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: TATYAHNA COSTELLO
Title or Position: SOCIAL WORKER
Credential:
Phone: 562-673-8959