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General NPI Number Information
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NPI Number | 1770792426
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Entity Type | Organization
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Legal Business Name | L.A. CADA
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Dates
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Enumeration Date | 05/21/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4013 W 145TH ST APT 1
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City | LAWNDALE
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State | CA
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Zip | 90260-1800
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Country | US
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Telephone | 310-626-2274
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Fax |
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Provider Business Mailing Address
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Address Line | 4013 W 145TH ST APT 1
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City | LAWNDALE
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State | CA
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Zip | 90260-1800
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Country | US
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Telephone | 310-626-2274
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Fax |
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Authorized Official
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Title or Position | INTERN
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Name | MS. JOYCE MARIE JOHNSON
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Credential |
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Telephone | 310-626-2274
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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 | RS8113
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License Number State | CA
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