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General NPI Number Information
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NPI Number | 1316181233
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Entity Type | Organization
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Legal Business Name | DEPARTMENT OF MENAL HELATH COMPTON
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Dates
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Enumeration Date | 04/22/2009
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Last Update Date | 04/22/2009
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Provider Practice Location Address
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Address Line | 921 E COMPTON BLVD
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City | COMPTON
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State | CA
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Zip | 90221-3303
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Country | US
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Telephone | 310-668-6900
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Fax |
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Provider Business Mailing Address
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Address Line | 921 E COMPTON BLVD
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City | COMPTON
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State | CA
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Zip | 90221-3303
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Country | US
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Telephone | 310-668-6900
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Fax |
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Authorized Official
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Title or Position | DISTRICT CHIEF
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Name | MS. JACQUELYN WILCOXEN
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Credential | LCSW
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Telephone | 323-418-4209
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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