Healthcare Provider Details

I. General information

NPI: 1871357335
Provider Name (Legal Business Name): MADE WITH LOVE PSYCHOTHERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2024
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2460 17TH AVE # 1126
SANTA CRUZ CA
95062-1869
US

IV. Provider business mailing address

4821 CLOVERLY AVE
TEMPLE CITY CA
91780-3809
US

V. Phone/Fax

Practice location:
  • Phone: 408-384-8168
  • Fax: 855-683-1876
Mailing address:
  • Phone: 626-215-5419
  • Fax: 855-683-1876

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. DIANNA QUACH
Title or Position: CLINCIAL PSYCHOLOGIST
Credential: PHD
Phone: 626-215-5419