Provider Demographics
NPI:1063372886
Name:DOVE, DE ANNA DE SHAUN (LCSW)
Entity type:Individual
Prefix:
First Name:DE ANNA
Middle Name:DE SHAUN
Last Name:DOVE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3680 WILSHIRE BLVD STE P04
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010-2709
Mailing Address - Country:US
Mailing Address - Phone:424-258-0155
Mailing Address - Fax:
Practice Address - Street 1:3680 WILSHIRE BLVD STE P04
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010-2709
Practice Address - Country:US
Practice Address - Phone:424-258-0155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-14
Last Update Date:2025-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1353181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical