Healthcare Provider Details

I. General information

NPI: 1841786191
Provider Name (Legal Business Name): FAY HOVE MA, LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2018
Last Update Date: 07/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 W TORRANCE BLVD STE 100
REDONDO BEACH CA
90277-3619
US

IV. Provider business mailing address

1536 23RD ST
MANHATTAN BEACH CA
90266-4045
US

V. Phone/Fax

Practice location:
  • Phone: 310-798-9000
  • Fax:
Mailing address:
  • Phone: 310-809-1750
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number107223
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: