NPIMap

Organization Active NPI

Los Angeles County Department of Mental Health

Doing business as GENESIS Countywide Older Adult Program

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Los Angeles, CA
National Provider Identifier
1083633929
Registry record updated Jul 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
LOS ANGELES COUNTY DEPARTMENT OF MENTAL HEALTH
Doing business as
GENESIS Countywide Older Adult Program
Practice address
510 S Vermont Ave
17TH Floor
Los Angeles, CA 90020-1992
Phone
(213) 351-7284
Fax
(213) 947-4579
NPI assigned
Jul 19, 2006
Last updated
Jul 11, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
LOS ANGELES COUNTY DEPARTMENT OF MENTAL HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 11, 2022

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

Authorized official

Name
Lisa H. Wong, PSY.D.
Title
Acting Director
Phone
(213) 738-4601

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

510 S Vermont Ave
17TH Floor
Los Angeles, CA 90020-1992

Mailing address

510 S Vermont Ave
Los Angeles, CA 90020-1992
Phone (213) 738-4601

Other names 1

  • GENESIS Countywide Older Adult Program Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031104000319 CA Part B Supplier - Clinic/Group Practice 7416869896 Receives reassigned benefits from 533 practitioners

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2230472Genesis Program510 S Vermont Ave, 17TH FL, Los Angeles, CA 90020Certificate of waiverJul 22, 2027

National Provider Directory

National Provider Directory
Tax ID family
La County Dept of Menta278 organizations share this tax ID, including this one
Part of
La County Dept of Menta

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

17707 Studebaker Rd
#150
Cerritos, CA 90703
Phone (310) 402-0688

1359 N Grand Ave
Fl 1
Covina, CA 91724
Phone (626) 430-2900

510 S Vermont Ave
Fl 17
Los Angeles, CA 90020
Phone (213) 332-1097

Practitioners & affiliated clinicians

Practitioners 574

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 574

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657497600000",
    "number": "1083633929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 S VERMONT AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900201992",
            "telephone_number": "213-738-4601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 S VERMONT AVE",
            "address_2": "17TH FLOOR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900201992",
            "telephone_number": "213-351-7284",
            "fax_number": "213-947-4579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOS ANGELES COUNTY DEPARTMENT OF MENTAL HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LOS ANGELES COUNTY DEPARTMENT OF MENTAL HEALTH",
        "enumeration_date": "2006-07-19",
        "last_updated": "2022-07-11",
        "certification_date": "2022-07-11",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "ACTING DIRECTOR",
        "authorized_official_telephone_number": "213-738-4601",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GENESIS Countywide Older Adult Program",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.