=====================================================
General NPI Number Information
=====================================================
NPI Number | 1245142868
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DMH HOMELESS OUTREACH & MOBILE ENGAGEMENT
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/18/2026
-----------------------------------------------------
Last Update Date | 09/18/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5601 E SLAUSON AVE FL 2
-----------------------------------------------------
City | COMMERCE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90040-2953
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 626-420-3905
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 207 GLENLOCH AVE
-----------------------------------------------------
City | LA PUENTE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91744-5215
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | HOME INTERN
-----------------------------------------------------
Name | EMELY NICOLE MENDEZ
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 626-420-3905
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 390200000X
-----------------------------------------------------
Taxonomy Name | Student in an Organized Health Care Education/Training Program
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------