Provider Demographics
NPI:1649480617
Name:LOVELACE, AUBREE (MFT)
Entity type:Individual
Prefix:MS
First Name:AUBREE
Middle Name:
Last Name:LOVELACE
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3303 N BROADWAY FL 4
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90031-2803
Mailing Address - Country:US
Mailing Address - Phone:323-450-5535
Mailing Address - Fax:
Practice Address - Street 1:3303 N BROADWAY FL 4
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90031-2803
Practice Address - Country:US
Practice Address - Phone:323-450-5535
Practice Address - Fax:323-432-5086
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48805106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist