Kaiser Permanente

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

License

MFC29709 Issued in CA

Legal business name

KAISER PERMANENTE

Practice address

5105 W Goldleaf Cir
Los Angeles, CA 90056-1269

Phone

(323) 298-3175

NPI assigned

Jun 5, 2007

Organization subpart

No

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

Authorized official

Name

Jim Selfa, LMFT

Title

Department Administrator

Phone

(323) 298-3175

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1841492212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4440 DENSMORE AVE",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914363461",
            "telephone_number": "818-788-9489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5105 W GOLDLEAF CIR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900561269",
            "telephone_number": "323-298-3175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAISER PERMANENTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-05",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "SELFA",
        "authorized_official_first_name": "JIM",
        "authorized_official_title_or_position": "DEPARTMENT ADMINISTRATOR",
        "authorized_official_telephone_number": "323-298-3175",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "CA",
            "license": "MFC29709",
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "CA",
            "license": "MFC29709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaiser Permanente
• Kaiser Permanente
• Kaiser Permanente
• Kaiser Permanente
• Kaiser Permanente
• Kaiser Permanente
• Kaiser Permanente Lamc
• Kaiser Permanente Los Angeles
• Kaiser Permanente, Sunset BL. la, ,Ca
• Kaiser Permenante

• Adolescent and Children Mental Health Clinic/Center in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Adolescent and Children Mental Health Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.