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NPI Code Detail

MEDICARE: MRS. ZOILA C. HENRIQUEZ

MEDICARE: MRS. ZOILA C. HENRIQUEZ
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
1171M00000XCase Manager/Care Coordinator

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1C022849OTHERCADEPARTMENT OF MENTAL HEALTH LOS ANGELES

General Provider Information

NPI Number : 1811149354
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ZOILA C. HENRIQUEZ
Provider Business Mailing Address
First Line : 12099 W WASHINGTON BLVD STE 200
Second Line :
City : LOS ANGELES
State : CA
Zip : 90066-2622
Country : US
Telephone Number : 310-751-1171
Fax Number : 310-313-7652
Provider Business Practice Location Address
First Line : 12099 W WASHINGTON BLVD STE 200
Second Line :
City : LOS ANGELES
State : CA
Zip : 90066-2622
Country : US
Telephone Number : 310-751-1171
Fax Number : 310-313-7652
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/15/2008
Last Update Date : 02/02/2011

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Directions to “ MRS. ZOILA C. HENRIQUEZ ” Practice Location

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