Provider Demographics
NPI:1316002025
Name:LOVE, SUSAN L (LMFT)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:L
Last Name:LOVE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6850 GUNN DR
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-1443
Mailing Address - Country:US
Mailing Address - Phone:510-287-8981
Mailing Address - Fax:510-339-9363
Practice Address - Street 1:1425 LEIMERT BLVD
Practice Address - Street 2:#302
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94602-1808
Practice Address - Country:US
Practice Address - Phone:510-287-8981
Practice Address - Fax:510-339-9363
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC35413101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health