Healthcare Provider Details

I. General information

NPI: 1205324027
Provider Name (Legal Business Name): BOBBY FRANKLIN LOVEDAY SUDCC II
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2018
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2750 G ST STE A&B
MERCED CA
95340-2953
US

IV. Provider business mailing address

2750 G ST STE A&B
MERCED CA
95340-2953
US

V. Phone/Fax

Practice location:
  • Phone: 209-961-6399
  • Fax:
Mailing address:
  • Phone: 209-961-6399
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374700000X
TaxonomyTechnician
License NumberCI33150621
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code374700000X
TaxonomyTechnician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: