Provider Demographics
NPI:1962806000
Name:LOVINGS, TRIVAN MARTINES
Entity type:Individual
Prefix:MR
First Name:TRIVAN
Middle Name:MARTINES
Last Name:LOVINGS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6836
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91510-6836
Mailing Address - Country:US
Mailing Address - Phone:323-389-5205
Mailing Address - Fax:
Practice Address - Street 1:150 S LOS ROBLES AVE STE 850
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-4630
Practice Address - Country:US
Practice Address - Phone:415-202-5159
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-17
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA999521041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical