NPIMap

Organization Active NPI

Los Angeles County Department of Mental Health

Doing business as SA4 Enhanced Care Management

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Los Angeles, CA
National Provider Identifier
1205595303
Registry record updated Sep 12, 2023
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
SA4 Enhanced Care Management
Practice address
3303 N Broadway FL 4
Los Angeles, CA 90031-2803
Phone
(213) 308-4467
NPI assigned
Dec 16, 2021
Last updated
Sep 12, 2023By 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 Sep 12, 2023

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
Director
Phone
(213) 738-4601

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care CoordinatorGroup: 193200000X MULTI-SPECIALTY GROUP 171M00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

3303 N Broadway FL 4
Los Angeles, CA 90031-2803

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
19IQMedicaidCA

Other names 1

  • SA4 Enhanced Care Management Doing business as

National Provider Directory

National Provider Directory
Tax ID family
La County Dept of Menta277 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

NPI Registry JSON

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

{
    "created_epoch": "1639612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694476800000",
    "number": "1205595303",
    "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": "3303 N BROADWAY FL 4",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900312803",
            "telephone_number": "213-308-4467"
        }
    ],
    "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": "2021-12-16",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "213-738-4601",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "19IQ",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SA4 Enhanced Care Management",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SA4 Enhanced Care Management",
            "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 Sep 12, 2023; 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.