Provider Demographics
NPI:1619600046
Name:LOVE, BRENTON JOSEPH (LMFT)
Entity type:Individual
Prefix:MR
First Name:BRENTON
Middle Name:JOSEPH
Last Name:LOVE
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:376 VISTA BAYA
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-3634
Mailing Address - Country:US
Mailing Address - Phone:714-331-2464
Mailing Address - Fax:
Practice Address - Street 1:26010 ACERO
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-2768
Practice Address - Country:US
Practice Address - Phone:949-354-2254
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-04
Last Update Date:2025-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA159509106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1619600046Medicaid