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General NPI Number Information
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NPI Number | 1871357335
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Entity Type | Organization
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Legal Business Name | MADE WITH LOVE THERAPY
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Dates
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Enumeration Date | 02/06/2024
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Last Update Date | 02/06/2024
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Provider Practice Location Address
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Address Line | 1925 46TH AVE UNIT 83
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City | CAPITOLA
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State | CA
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Zip | 95010
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Country | US
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Telephone | 408-384-8168
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Fax |
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Provider Business Mailing Address
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Address Line | 4821 CLOVERLY AVE
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City | TEMPLE CITY
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State | CA
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Zip | 91780-3809
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Country | US
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Telephone | 626-215-5419
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Fax |
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Authorized Official
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Title or Position | CLINCIAL PSYCHOLOGIST
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Name | DR. DIANNA QUACH
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Credential | PHD
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Telephone | 626-215-5419
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TP2701X
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Taxonomy Name | Group Psychotherapy Psychologist
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License Number |
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License Number State |
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