Provider Demographics
NPI:1023785771
Name:REBECCA LOVE LCSW INC
Entity type:Organization
Organization Name:REBECCA LOVE LCSW INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:LOVE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:916-474-9325
Mailing Address - Street 1:7940 CALIFORNIA AVE STE 11
Mailing Address - Street 2:
Mailing Address - City:FAIR OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:95628-7155
Mailing Address - Country:US
Mailing Address - Phone:916-474-9325
Mailing Address - Fax:916-333-3442
Practice Address - Street 1:7940 CALIFORNIA AVE STE 11
Practice Address - Street 2:
Practice Address - City:FAIR OAKS
Practice Address - State:CA
Practice Address - Zip Code:95628-7155
Practice Address - Country:US
Practice Address - Phone:916-474-9325
Practice Address - Fax:916-333-3442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-29
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)