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General NPI Number Information
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NPI Number | 1275886111
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Entity Type | Organization
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Legal Business Name | L.A. COUNTY DEPT MENTAL HEALTH
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Dates
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Enumeration Date | 10/16/2012
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Last Update Date | 10/16/2012
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Provider Practice Location Address
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Address Line | 467 ARNAZ DR APT 111
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City | LOS ANGELES
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State | CA
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Zip | 90048-3950
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Country | US
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Telephone | 424-249-3873
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Fax |
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Provider Business Mailing Address
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Address Line | 467 ARNAZ DR APT 111
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City | LOS ANGELES
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State | CA
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Zip | 90048-3950
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Country | US
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Telephone | 480-200-6793
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Fax |
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Authorized Official
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Title or Position | LICENSED PSYCH TECH
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Name | MARK S MEZA
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Credential |
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Telephone | 424-249-3873
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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 | 34614
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License Number State | CA
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