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General NPI Number Information
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NPI Number | 1205914116
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Entity Type | Organization
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Legal Business Name | DOWNTOWN MENTAL HEALTH CENTER
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 529 MAPLE AVE
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City | LOS ANGELES
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State | CA
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Zip | 90013-1511
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Country | US
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Telephone | 213-430-6794
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Fax |
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Provider Business Mailing Address
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Address Line | 529 MAPLE AVE
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City | LOS ANGELES
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State | CA
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Zip | 90013-1511
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Country | US
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Telephone | 213-430-6794
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Fax |
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Authorized Official
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Title or Position | PSYCHIATRIC SOCIAL WORKER
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Name | MOHAMED ZIAUDDIN
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Credential | MSW
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Telephone | 213-430-6794
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | ASW 13098
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License Number State | CA
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