Provider Demographics
NPI:1659761849
Name:LOVE PSYCHOLOGY, INC.
Entity Type:Organization
Organization Name:LOVE PSYCHOLOGY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:YVONNE
Authorized Official - Middle Name:ROBLES
Authorized Official - Last Name:LOVE
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, MS
Authorized Official - Phone:559-250-5646
Mailing Address - Street 1:2204 GARNET AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92109-3771
Mailing Address - Country:US
Mailing Address - Phone:619-559-8412
Mailing Address - Fax:619-821-8914
Practice Address - Street 1:2204 GARNET AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92109-3771
Practice Address - Country:US
Practice Address - Phone:619-559-8412
Practice Address - Fax:619-821-8914
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-27
Last Update Date:2017-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY18321103T00000X, 103TA0400X, 103TA0700X, 103TC0700X, 103TF0200X, 103TH0004X, 103TH0100X, 103TP2701X, 103TR0400X, 305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)Group - Single Specialty
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & AgingGroup - Single Specialty
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensicGroup - Single Specialty
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealthGroup - Single Specialty
No103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth ServiceGroup - Single Specialty
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Single Specialty
No103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitationGroup - Single Specialty
No305R00000XManaged Care OrganizationsPreferred Provider OrganizationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA121122, 125417OtherDWC INDUSTRIAL MEDICINE COUNCIL
CA1911930832OtherCAQH COMPANY ID
CA1911930832OtherCAQH ACH ID
CAPSY18321OtherBOARD OF PSYCHOLOGY
CA1911930832OtherCAQH ACH ID