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General NPI Number Information
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NPI Number | 1013145242
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Entity Type | Organization
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Legal Business Name | DEPARTMENT OF MENTAL HEALTH
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Dates
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Enumeration Date | 06/25/2009
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Last Update Date | 06/25/2009
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Provider Practice Location Address
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Address Line | 8300 S VERMONT AVE FL 1 LATONYA WOOD, PH.D.
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City | LOS ANGELES
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State | CA
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Zip | 90044-3422
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Country | US
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Telephone | 323-525-6431
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Fax |
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Provider Business Mailing Address
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Address Line | 6041 GRANDVIEW AVE
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City | YORBA LINDA
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State | CA
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Zip | 92886-5301
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Country | US
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Telephone | 714-914-9006
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Fax | 714-921-2120
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Authorized Official
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Title or Position | DIRECTOR OF TRAINING, PSYCHOLOGIST
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Name | DR. LATONYA WOOD
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Credential | PH.D.
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Telephone | 323-525-6431
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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