Provider Demographics
NPI:1013145242
Name:DEPARTMENT OF MENTAL HEALTH
Entity Type:Organization
Organization Name:DEPARTMENT OF MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF TRAINING, PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LATONYA
Authorized Official - Middle Name:
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:323-525-6431
Mailing Address - Street 1:6041 GRANDVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92886-5301
Mailing Address - Country:US
Mailing Address - Phone:714-914-9006
Mailing Address - Fax:714-921-2120
Practice Address - Street 1:8300 S VERMONT AVE FL 1
Practice Address - Street 2:LATONYA WOOD, PH.D.
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90044-3422
Practice Address - Country:US
Practice Address - Phone:323-525-6431
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-25
Last Update Date:2009-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable