| Ab 3632 Assessment Unit Sector I | |
|
11303 W Washington Blvd Suite 200 Los Angeles CA 90066-6003 | |
| (310) 268-2560 | |
| Not Available |
| Full Name | Ab 3632 Assessment Unit Sector I |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 11303 W Washington Blvd, Los Angeles, California |
| Authorized Official Name and Position | Lisa H. Wong (ACTING DIRECTOR) |
| Authorized Official Contact | 2137384601 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ab 3632 Assessment Unit Sector I 510 S Vermont Ave Los Angeles CA 90020-1992 Ph: (213) 738-4601 | Ab 3632 Assessment Unit Sector I 11303 W Washington Blvd Suite 200 Los Angeles CA 90066-6003 Ph: (310) 268-2560 |
| NPI Number | 1235145475 |
|---|---|
| Provider Enumeration Date | 07/31/2006 |
| Last Update Date | 07/25/2022 |
| Certification Date | 07/25/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235145475 | NPI | - | NPPES |
| 7437 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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