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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 : 1265456677
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 : 90020-1992
Country : US
Telephone Number : 213-738-4601
Fax Number :
Provider Business Practice Location Address
First Line : 1605 EASTLAKE AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90033-1009
Country : US
Telephone Number : 323-226-8806
Fax Number :
Authorized Official
Title or Position : ACTING DIRECTOR
Name : LISA H. WONG
Credential : PSY.D.
Telephone Number : 213-738-4601
Provider Enumeration Date : 07/27/2006
Last Update Date : 07/18/2022

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

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