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General NPI Number Information
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NPI Number | 1942954094
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Entity Type | Organization
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Legal Business Name | LOS ANGELES COUNTY DEPARTMENT OF MENTAL HEALTH
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Dates
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Enumeration Date | 02/08/2022
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Last Update Date | 09/13/2022
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Provider Practice Location Address
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Address Line | 12021 WILMINGTON AVENUE, 1ST FLOOR STE 1D
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City | LOS ANGELES
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State | CA
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Zip | 90059-3099
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Country | US
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Telephone | 213-947-6486
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Fax | 213-402-2504
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Provider Business Mailing Address
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Address Line | 510 S VERMONT AVE
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City | LOS ANGELES
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State | CA
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Zip | 90020-1992
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Country | US
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Telephone | 213-738-4601
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Fax |
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Authorized Official
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Title or Position | ACTING DIRECTOR
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Name | LISA H. WONG
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Credential | PSY.D.
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Telephone | 213-738-4601
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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