Healthcare Provider Details
I. General information
NPI: 1205034691
Provider Name (Legal Business Name): LOVINGLY QUITANIA PARK PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/06/2007
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
725 WELCH RD
PALO ALTO CA
94304-1601
US
IV. Provider business mailing address
725 WELCH RD
PALO ALTO CA
94304-1601
US
V. Phone/Fax
- Phone: 650-497-8000
- Fax:
- Phone: 650-497-8000
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | PSY25525 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: