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NPI Code Detail

MEDICARE: MS. KRISTEN MARIE LOVE LCSW

MEDICARE: MS. KRISTEN MARIE LOVE LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker26760CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
16804OTHERCASACRAMENTO COUNTY MH ID#

General Provider Information

NPI Number : 1487664868
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KRISTEN MARIE LOVE LCSW
Provider Business Mailing Address
First Line : 2750 SUTTERVILLE RD
Second Line :
City : SACRAMENTO
State : CA
Zip : 95820-1024
Country : US
Telephone Number : 916-492-7240
Fax Number : 916-736-1072
Provider Business Practice Location Address
First Line : 2750 SUTTERVILLE RD
Second Line :
City : SACRAMENTO
State : CA
Zip : 95820-1024
Country : US
Telephone Number : 916-492-7240
Fax Number : 916-736-1072
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2006
Last Update Date : 02/15/2012

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