NPIMap

Organization Active NPI

Los Angeles County Department of Mental Health

Doing business as Specialized Foster Care Wateridge

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Los Angeles, CA
National Provider Identifier
1831103191
Registry record updated May 6, 2024
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
Specialized Foster Care Wateridge
Practice address
5110 W Goldleaf Cir FL 2
Los Angeles, CA 90056-1282
Phone
(310) 290-8610
Fax
(323) 290-3180
NPI assigned
Jul 29, 2006
Organization subpart
Yes
Parent organization
LOS ANGELES COUNTY DEPARTMENT OF MENTAL HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 6, 2024

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

5110 W Goldleaf Cir FL 2
Los Angeles, CA 90056-1282

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
7612MedicaidCA

Other names 1

  • SPECIALIZED FOSTER CARE WATERIDGE Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Heninger Owe277 organizations share this tax ID, including this one
Part of
Heninger Owe

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

5110 W Goldleaf Cir
Los Angeles, CA 90056
Phone (323) 290-8562

5110 W Goldleaf Cir
Fl 2
Los Angeles, CA 90056
Phone (323) 290-3180

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714953600000",
    "number": "1831103191",
    "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": "5110 W GOLDLEAF CIR FL 2",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900561282",
            "telephone_number": "310-290-8610",
            "fax_number": "323-290-3180"
        }
    ],
    "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": "2006-07-29",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "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": "7612",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SPECIALIZED FOSTER CARE WATERIDGE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SPECIALIZED FOSTER CARE WATERIDGE",
            "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 May 6, 2024; 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.