Provider Demographics
NPI:1932854924
Name:LOVE, SUMARIA
Entity type:Individual
Prefix:
First Name:SUMARIA
Middle Name:
Last Name:LOVE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5960 S LAND PARK DR # 415
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95822-3313
Mailing Address - Country:US
Mailing Address - Phone:916-410-8618
Mailing Address - Fax:
Practice Address - Street 1:5650 MARCONI AVE
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-4462
Practice Address - Country:US
Practice Address - Phone:916-410-8618
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-17
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMastectomy FitterGroup - Single Specialty
No171400000XOther Service ProvidersHealth & Wellness Coach
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral