Provider Demographics
NPI:1801185111
Name:LOS ANGELES COUNTY DEPARTMENT OF MENTAL HEALTH
Entity Type:Organization
Organization Name:LOS ANGELES COUNTY DEPARTMENT OF MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISING PSYCHIATRIC SOCIAL WORK
Authorized Official - Prefix:MR
Authorized Official - First Name:SANJE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAU
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:562-651-5025
Mailing Address - Street 1:12440 IMPERIAL HWY STE 116
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90650-8347
Mailing Address - Country:US
Mailing Address - Phone:562-651-5025
Mailing Address - Fax:562-868-3749
Practice Address - Street 1:12440 IMPERIAL HWY STE 116
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-8347
Practice Address - Country:US
Practice Address - Phone:562-651-5025
Practice Address - Fax:562-868-3749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-07
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Multi-Specialty