NPIMap

Organization Active NPI

Los Angeles County Department of Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Culver City, CA
National Provider Identifier
1639623267
Registry record updated Aug 30, 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
Practice address
4040 Duquesne Ave
Culver City, CA 90232-2804
Phone
(310) 253-6332
Fax
(310) 253-6117
NPI assigned
Aug 11, 2016
Organization subpart
Yes
Parent organization
LOS ANGELES COUNTY DEPARTMENT OF MENTAL HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 30, 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

4040 Duquesne Ave
Culver City, CA 90232-2804

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
7984MedicaidCA

Other names 1

  • CCMET Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Palisoc Ado276 organizations share this tax ID, including this one
Part of
Palisoc Ado

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

4040 Duquesne Ave
Culver City, CA 90232
Phone (310) 253-6332

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1470873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661817600000",
    "number": "1639623267",
    "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": "4040 DUQUESNE AVE",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902322804",
            "telephone_number": "310-253-6332",
            "fax_number": "310-253-6117"
        }
    ],
    "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": "2016-08-11",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7984",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CCMET",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CCMET",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Culver City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2022; 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.