Department of Mental Health, la County

Primary specialty

Point of ServiceTaxonomy code 305S00000X

License

MANTELA352PR Issued in WA

Legal business name

DEPARTMENT OF MENTAL HEALTH, LA COUNTY

Practice address

4067 W 3Rd St Apt 106
Los Angeles, CA 90020-3168

Phone

(213) 807-4639

NPI assigned

Mar 11, 2010

Last updated

Mar 11, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Marvin Southard, DSW

Title

Director of Mental Health

Phone

(213) 430-6700

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1268265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268265600000",
    "number": "1790008258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4067 W. 3RD ST",
            "address_2": "#106",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90020",
            "telephone_number": "213-807-4639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4067 W 3RD ST APT 106",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900203168",
            "telephone_number": "213-807-4639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEPARTMENT OF MENTAL HEALTH, LA COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-11",
        "last_updated": "2010-03-11",
        "status": "A",
        "authorized_official_last_name": "SOUTHARD",
        "authorized_official_first_name": "MARVIN",
        "authorized_official_title_or_position": "DIRECTOR OF MENTAL HEALTH",
        "authorized_official_telephone_number": "213-430-6700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DSW"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "AZ",
            "license": "D05195986",
            "primary": false
        },
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "WA",
            "license": "MANTELA352PR",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARIZONA IDENTIFICATION CARD",
            "identifier": "D05195986",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Department of Mental Health
• Department of Mental Health
• Department of Mental Health
• Department of Mental Health
• Department of Mental Health
• Department of Veteran Affairs
• Department of Veterans Affairs
• Department of Veterans Affairs of the State of California (Veterans Home of California - West Los Angeles)
• Department of Veterans Affairs of the State of California (CDVA Veterans Home of California West Los Angeles)
• Department of Vetrans Affairs

• Point of Service in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Point of Service in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2010; 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.