Provider Demographics
NPI:1003115544
Name:LOS ANGELES UNIFIED SCHOOL DISTRICT
Entity Type:Organization
Organization Name:LOS ANGELES UNIFIED SCHOOL DISTRICT
Other - Org Name:BALBOA STUDENT AND FAMILY WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARGARITA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOBE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-241-0558
Mailing Address - Street 1:333 S. BEAUDRY AVE
Mailing Address - Street 2:SMH, FLOOR 29
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90017-1466
Mailing Address - Country:US
Mailing Address - Phone:818-997-2640
Mailing Address - Fax:818-996-9850
Practice Address - Street 1:6655 BALBOA BLVD
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91406-5529
Practice Address - Country:US
Practice Address - Phone:818-758-2300
Practice Address - Fax:818-996-9850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-23
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health