Healthcare Provider Details

I. General information

NPI: 1942326871
Provider Name (Legal Business Name): MENTAL HEALTH AMERICA OF LOS ANGELES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 10/29/2021
Certification Date: 10/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1609 E PALMDALE BLVD STE G
PALMDALE CA
93550-4881
US

IV. Provider business mailing address

200 PINE AVE STE 400
LONG BEACH CA
90802-3039
US

V. Phone/Fax

Practice location:
  • Phone: 661-947-1595
  • Fax: 661-575-1682
Mailing address:
  • Phone: 562-285-1330
  • Fax: 562-263-3395

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: DR. CHRISTINA MILLER
Title or Position: PRESIDENT AND CEO
Credential: PHD
Phone: 562-285-1330