Healthcare Provider Details

I. General information

NPI: 1720954910
Provider Name (Legal Business Name): LOS ANGELES COUNTY DEPARTMENT OF MENTAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2025
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1359 N. GRAND AVE.
COVINA CA
91724-1016
US

IV. Provider business mailing address

1359 N. GRAND AVE.
COVINA CA
91724-1016
US

V. Phone/Fax

Practice location:
  • Phone: 727-268-0917
  • Fax: 213-840-6453
Mailing address:
  • Phone: 727-268-0917
  • Fax: 213-840-6453

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DR. LISA H. WONG
Title or Position: DIRECTOR OF MENTAL HEALTH
Credential: PSY.D.
Phone: 213-947-6670