Provider Demographics
NPI:1275886111
Name:L.A. COUNTY DEPT MENTAL HEALTH
Entity Type:Organization
Organization Name:L.A. COUNTY DEPT MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCH TECH
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:S
Authorized Official - Last Name:MEZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:424-249-3873
Mailing Address - Street 1:467 ARNAZ DR APT 111
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-3950
Mailing Address - Country:US
Mailing Address - Phone:480-200-6793
Mailing Address - Fax:
Practice Address - Street 1:467 ARNAZ DR APT 111
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-3950
Practice Address - Country:US
Practice Address - Phone:424-249-3873
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-16
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34614251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health