Provider Demographics
NPI:1750121638
Name:LOVE, LUCY DORALEE (DACM, LAC)
Entity type:Individual
Prefix:DR
First Name:LUCY
Middle Name:DORALEE
Last Name:LOVE
Suffix:
Gender:F
Credentials:DACM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1866 MATIN CIR UNIT 111
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92069-3384
Mailing Address - Country:US
Mailing Address - Phone:305-542-7001
Mailing Address - Fax:
Practice Address - Street 1:1582 W SAN MARCOS BLVD STE 304
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92078-4081
Practice Address - Country:US
Practice Address - Phone:305-542-7001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-29
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20053171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty