Healthcare Provider Details

I. General information

NPI: 1295823193
Provider Name (Legal Business Name): LOS ANGELES COUNTY OF DEPARTMNENT OF MENTAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17707 STUDEBAKER RD
CERRITOS CA
90703-2640
US

IV. Provider business mailing address

11854 TRURO AVE # C
HAWTHORNE CA
90250-2806
US

V. Phone/Fax

Practice location:
  • Phone: 562-467-0209
  • Fax:
Mailing address:
  • Phone: 310-675-7677
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. ERIC V SMITH
Title or Position: MEDICAL CASE WORKER 1
Credential:
Phone: 562-467-0209