Provider Demographics
NPI:1477312338
Name:LOVELESS, ALLISHA KAY
Entity Type:Individual
Prefix:
First Name:ALLISHA
Middle Name:KAY
Last Name:LOVELESS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALLISHA
Other - Middle Name:KAY
Other - Last Name:LARSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:505 M ST
Mailing Address - Street 2:
Mailing Address - City:RIO LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:95673-2218
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:505 M ST
Practice Address - Street 2:
Practice Address - City:RIO LINDA
Practice Address - State:CA
Practice Address - Zip Code:95673-2218
Practice Address - Country:US
Practice Address - Phone:916-287-4067
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-14
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist