Provider Demographics
NPI:1306241526
Name:LOVE, TAMIKO D (LCSW)
Entity type:Individual
Prefix:MRS
First Name:TAMIKO
Middle Name:D
Last Name:LOVE
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 1:1225 W 190TH ST
Mailing Address - Street 2:SUITE 310
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90248-4320
Mailing Address - Country:US
Mailing Address - Phone:310-900-4838
Mailing Address - Fax:310-538-5518
Practice Address - Street 1:1225 W 190TH ST
Practice Address - Street 2:SUITE 310
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90248-4320
Practice Address - Country:US
Practice Address - Phone:310-900-4838
Practice Address - Fax:310-538-5518
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-30
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW640141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical