Individual provider Active NPI

Kevin Boyd Lovelace, BCBA

  • Behavior Analyst
  • South Pasadena, CA
National Provider Identifier
1821475658
Registry record updated Oct 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-14-17541 Issued in CA
Practice address
99 Pasadena Ave Ste 10C
South Pasadena, CA 91030-6142
Phone
(619) 560-5481
NPI assigned
Apr 30, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-14-17541 CA Primary

Addresses

Primary practice location

99 Pasadena Ave Ste 10C
South Pasadena, CA 91030-6142

Mailing address

1129 S Lark Ellen Ave
West Covina, CA 91791-3530
Phone (626) 251-7537

Other practice location 1

1129 S Lark Ellen Ave
West Covina, CA 91791-3530
Phone (626) 251-7537

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1430352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1821475658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1129 S LARK ELLEN AVE",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917913530",
            "telephone_number": "626-251-7537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 PASADENA AVE STE 10C",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910306142",
            "telephone_number": "619-560-5481"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1129 S Lark Ellen Ave",
            "address_purpose": "LOCATION",
            "city": "West Covina",
            "state": "CA",
            "postal_code": "917913530",
            "country_code": "US",
            "telephone_number": "626-251-7537",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOVELACE",
        "first_name": "KEVIN",
        "middle_name": "BOYD",
        "name_prefix": "Mr.",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-30",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-14-17541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.