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General NPI Number Information
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NPI Number | 1689906562
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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 | 02/03/2010
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Last Update Date | 02/03/2010
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Provider Practice Location Address
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Address Line | 1000 W. CARSON STREET
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City | TORRANCE
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State | CA
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Zip | 90501
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Country | US
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Telephone | 310-222-1732
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Fax | 310-222-5651
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Provider Business Mailing Address
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Address Line | 1000 W CARSON ST
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City | TORRANCE
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State | CA
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Zip | 90502-2004
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Country | US
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Telephone | 310-222-1732
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Fax | 310-222-5651
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Authorized Official
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Title or Position | SR. MHC RN
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Name | MS. VICKIE BURRIS
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Credential | 05/07
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Telephone | 310-222-1732
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number | 362151
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License Number State | CA
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