=====================================================
General NPI Number Information
=====================================================
NPI Number | 1912855057
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LOS ANGELES COUNTY DEPARTMENT OF MENTAL HEALTH
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/16/2026
-----------------------------------------------------
Last Update Date | 03/16/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3303 N. BROADWAY, SUITE 300, 4TH FLOOR
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90031-2305
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 213-943-8790
-----------------------------------------------------
Fax | 213-325-4931
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3303 N. BROADWAY, SUITE 300, 4TH FLOOR
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90031-2305
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 213-943-8790
-----------------------------------------------------
Fax | 213-325-4931
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | DR. LISA H. WONG
-----------------------------------------------------
Credential | PSY.D.
-----------------------------------------------------
Telephone | 213-947-6670
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM0801X
-----------------------------------------------------
Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------