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
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1588511240
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	:	1741 EAST 120TH STREET, 3RD FL
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90059-1100
Country	:	US
Telephone Number	:	424-454-6200
Fax Number	:	424-337-4037

Authorized Official
Title or Position	:	DIRECTOR OF MENTAL HEALTH
Name	:	DR. LISA WONG
Credential	:	PSYCH. D
Telephone Number	:	213-947-6670

Provider Enumeration Date	:	03/12/2026
Last Update Date	:	03/12/2026

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

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