Healthcare Provider Details

I. General information

NPI: 1144472945
Provider Name (Legal Business Name): LOS ANGELES UNIFIED SCHOOL DISTRICT SCHOOL MENTAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2008
Last Update Date: 10/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6651 BALBOA BLVD
VAN NUYS CA
91406-5529
US

IV. Provider business mailing address

6651 BALBOA BLVD
VAN NUYS CA
91406-5529
US

V. Phone/Fax

Practice location:
  • Phone: 818-997-2640
  • Fax: 818-996-9850
Mailing address:
  • Phone: 818-997-2640
  • Fax: 818-996-9850

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State

VIII. Authorized Official

Name: MISS ANASHEH SOPHIA ABRAMIYAN
Title or Position: SOCIAL WORK INTERN
Credential:
Phone: 818-425-1258