Individual provider Active NPI

Christina Eguizabal Love, PSY.D.

  • Clinical Neuropsychologist
  • Baltimore, MD
National Provider Identifier
1710332697
Registry record updated Aug 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
05861 Issued in MD
Practice address
1750 E Fairmount Ave
Baltimore, MD 21231
Phone
(443) 923-9400
Fax
(443) 923-4403
NPI assigned
Apr 28, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 05861 MD Primary

Addresses

Primary practice location

1750 E Fairmount Ave
Baltimore, MD 21231

Mailing address

707 N Broadway
Baltimore, MD 21205-1832
Phone (443) 923-7926

Other practice location 1

707 N Broadway
Room 3094
Baltimore, MD 21205-1832
Phone (443) 923-7926

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231223000133 MD Practitioner - Clinical Psychologist 2567812027 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kennedy Krieger Associates CurrentSince Oct 10, 2023 Accepting new patients
Kennedy Krieger Associates CurrentSince Oct 10, 2023 Accepting new patients

Locations

1741 Ashland Ave
Rm 646
Baltimore, MD 21205
Phone (443) 923-1842

707 N Broadway
Rm 3094
Baltimore, MD 21205
Phone (443) 923-7926

1750 E Fairmount Ave
Baltimore, MD 21231
Phone (443) 923-5900

707 N Broadway
Baltimore, MD 21205
Phone (443) 923-1870

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1461801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535587200000",
    "number": "1710332697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 N BROADWAY",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212051832",
            "telephone_number": "443-923-7926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 E FAIRMOUNT AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21231",
            "telephone_number": "443-923-9400",
            "fax_number": "443-923-4403"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "707 N Broadway",
            "address_2": "Room 3094",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212051832",
            "country_code": "US",
            "telephone_number": "443-923-7926",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOVE",
        "first_name": "CHRISTINA",
        "middle_name": "EGUIZABAL",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-28",
        "last_updated": "2018-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MD",
            "license": "05861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.