Healthcare Provider Details

I. General information

NPI: 1740191022
Provider Name (Legal Business Name): LOS ANGELES COUNTY DEPARTMENT OF MENTAL HEALH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 E. AVE I, SUITE A
LANCASTER CA
93535-1607
US

IV. Provider business mailing address

510 S VERMONT AVE
LOS ANGELES CA
90020-1912
US

V. Phone/Fax

Practice location:
  • Phone: 213-259-4059
  • Fax:
Mailing address:
  • Phone: 213-947-6670
  • Fax:

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
Credential: PSYCH. D.
Phone: 213-947-6670