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NPI Code Detail

MEDICARE: LOS ANGELES COUNTY DEPARTMENT OF MENTAL HEALTH

MEDICARE: LOS ANGELES COUNTY DEPARTMENT OF MENTAL HEALTH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1093190621
Entity Type Code : Organization
Provider Name (Legal Business Name) : LOS ANGELES COUNTY DEPARTMENT OF MENTAL HEALTH
Provider Business Mailing Address
First Line : 510 S VERMONT AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90020-1912
Country : US
Telephone Number : 213-947-6670
Fax Number :
Provider Business Practice Location Address
First Line : 425 E. AVE I, STE A
Second Line :
City : LANCASTER
State : CA
Zip : 93535-1916
Country : US
Telephone Number : 661-223-3831
Fax Number : 661-537-2937
Authorized Official
Title or Position : DIRECTOR
Name : LISA H. WONG
Credential : PSY.D.
Telephone Number : 213-947-6670
Provider Enumeration Date : 07/24/2015
Last Update Date : 06/09/2026

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Directions to “LOS ANGELES COUNTY DEPARTMENT OF MENTAL HEALTH ” Practice Location

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