MEDICARE: COMPTON

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
1	163WP0808X	Psychiatric/Mental Health Registered Nurse	250177	CA

General Provider Information

NPI Number	:	1548347743
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPTON

Provider Business Mailing Address
First Line	:	803 E VICTORIA ST
Second Line	:	UNIT 132
City	:	CARSON
State	:	CA
Zip	:	90746-1565
Country	:	US
Telephone Number	:	310-354-2939
Fax Number	:

Provider Business Practice Location Address
First Line	:	921 E COMPTON BLVD
Second Line	:
City	:	COMPTON
State	:	CA
Zip	:	90221-3303
Country	:	US
Telephone Number	:	310-668-6891
Fax Number	:

Authorized Official
Title or Position	:	MH COUNSELOR RN
Name	:	ALICE E JAMES
Credential	:
Telephone Number	:	310-668-6891

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	08/22/2020

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1770669442 — CYNTHIA B ALCARAZ MSW
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1922186865 — COMPTON MENTAL HEALTH
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Directions to “COMPTON ” Practice Location

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