Department of Health Services

Primary specialty

Prison Health Clinic/CenterTaxonomy code 261QP2400X

License

14185 Issued in CA

Legal business name

DEPARTMENT OF HEALTH SERVICES

Practice address

450 Bauchet St
MSB ----Room E873
Los Angeles, CA 90012-2907

Phone

(323) 568-4550

NPI assigned

May 31, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Michele M Green, BSN, PHN, MSN, NP

Title

Nurse Practitioner Whcnp

Phone

(310) 702-4285

Specialties & licenses 1

Addresses

Other names 1

• Los Angeles County Sheriff's Department Other name

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1464652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464652800000",
    "number": "1043668023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 BAUCHET ST",
            "address_2": "MSB ----ROOM E873",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900122907",
            "telephone_number": "323-568-4550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 BAUCHET ST",
            "address_2": "MSB ----ROOM E873",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900122907",
            "telephone_number": "323-568-4550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEPARTMENT OF HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-31",
        "last_updated": "2016-05-31",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "NURSE PRACTITIONER  WHCNP",
        "authorized_official_telephone_number": "310-702-4285",
        "authorized_official_credential": "BSN, PHN, MSN, NP"
    },
    "taxonomies": [
        {
            "code": "261QP2400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Prison Health",
            "state": "CA",
            "license": "14185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Los Angeles County Sheriff's Department",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Tapinder Kaur Deol, DDS
• Pamela Law Deomampo, M.D.
• Deorosan Professional Medical Corporation
• Verretta Deorosan, M.D.
• Tyler Depalma-Shields
• Department of Mental Health
• Department of Mental Health
• Department of Mental Health
• Department of Mental Health
• Department of Mental Health

• Prison Health Clinic/Center in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Prison Health Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.