Healthcare Provider Details

I. General information

NPI: 1245142868
Provider Name (Legal Business Name): DMH HOMELESS OUTREACH & MOBILE ENGAGEMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5601 E SLAUSON AVE FL 2
COMMERCE CA
90040-2953
US

IV. Provider business mailing address

207 GLENLOCH AVE
LA PUENTE CA
91744-5215
US

V. Phone/Fax

Practice location:
  • Phone: 626-420-3905
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name: EMELY NICOLE MENDEZ
Title or Position: HOME INTERN
Credential:
Phone: 626-420-3905