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NPI Code Detail

MEDICARE: UNITED STATES VETERANS INITIATIVE - LONG BEACH

MEDICARE: UNITED STATES VETERANS INITIATIVE - LONG BEACH
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
1106H00000XMarriage & Family Therapist
2251B00000XCase Management Agency
3261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1730222688
Entity Type Code : Organization
Provider Name (Legal Business Name) : UNITED STATES VETERANS INITIATIVE - LONG BEACH
Provider Business Mailing Address
First Line : 800 W 6TH ST STE 1505
Second Line :
City : LOS ANGELES
State : CA
Zip : 90017-2742
Country : US
Telephone Number : 213-760-4630
Fax Number :
Provider Business Practice Location Address
First Line : 2001 RIVER AVE
Second Line :
City : LONG BEACH
State : CA
Zip : 90810-3622
Country : US
Telephone Number : 562-388-8016
Fax Number : 562-388-7991
Authorized Official
Title or Position : MEDICAL BILLING PROJECT COORDINATOR
Name : MR. LISA R JACKSON-ZENO
Credential :
Telephone Number : 213-760-4630
Provider Enumeration Date : 02/14/2007
Last Update Date : 07/07/2025

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Directions to “UNITED STATES VETERANS INITIATIVE - LONG BEACH ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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