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General NPI Number Information
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NPI Number | 1851548721
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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 | 08/22/2008
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 4040 ADAIR ST
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City | LOS ANGELES
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State | CA
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Zip | 90011-2902
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Country | US
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Telephone | 323-388-7053
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Fax |
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Provider Business Mailing Address
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Address Line | 4040 ADAIR ST
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City | LOS ANGELES
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State | CA
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Zip | 90011-2902
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Country | US
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Telephone | 323-388-7053
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Fax |
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Authorized Official
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Title or Position | INTERN
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Name | MONICA ALEJANDRA HERNANDEZ
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Credential |
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Telephone | 323-388-7053
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273R00000X
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Taxonomy Name | Psychiatric Hospital Unit
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 273Y00000X
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Taxonomy Name | Rehabilitation Hospital Unit
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License Number | X
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License Number State | CA
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