LOS ANGELES COUNTY DEPARTMENT OF MENTAL HEALTH (NPI# 1043759855) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043759855 |
| Entity Type | Organization |
| Organization Name | LOS ANGELES COUNTY DEPARTMENT OF MENTAL HEALTH |
| Other Organization Name | AFH - MLK HAVEN CLINIC |
| Practice Address |
12021 Wilmington Ave Los Angeles CA 90059 |
| Mailing Address |
550 S Vermont Ave Los Angeles CA 90020-1912 |
| Practice Telephone | 4243382801 |
| Practice Fax Number | 3102230319 |
| Mailing Telephone | 2137384601 |
| Mailing Fax Number | 2133861297 |
| Enumeration Date | 2017-02-14 |
| Last Update Date | 2018-06-19 |
| Authorized Official Name | DR. JONATHAN E. SHERIN (DIRECTOR) |
| Authorized Official Telephone | 2137384601 |
| Authorized Official Credential | M.D., PH.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | - |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 6864B | 05 |
| Other Name | Type Code |
|---|---|
| AFH - MLK Haven Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962016527 | Los Angeles County Department of Mental Health | Clinic/Center | 2934 E Garvey Ave South Ste 230, West Covina, CA 91791-6101 | 2020-09-01 |
| 1760003859 | Los Angeles County Department of Mental Health | Clinic/Center | 1000 W Avenue J, Lancaster, CA 93534-3329 | 2020-04-30 |
| 1073158622 | Los Angeles County Department of Mental Health | Clinic/Center | 3303 N. Broadway Ave., 3rd/4th Floor, Los Angeles, CA 90031-0061 | 2019-11-07 |
| 1144787961 | Los Angeles County Department of Mental Health | Clinic/Center | 813 E 4th Pl, Los Angeles, CA 90013-1805 | 2019-02-28 |
| 1427515246 | Los Angeles County Department of Mental Health | Clinic/Center | 11110 W Pico Blvd, Los Angeles, CA 90064-1709 | 2019-02-28 |
| 1396202438 | Los Angeles County Department of Mental Health | Clinic/Center | 15777 Bowdoin St # J110a, Pacific Palisades, CA 90272-3523 | 2019-02-25 |
| 1912478348 | Los Angeles County Department of Mental Health | Clinic/Center | 550 S Vermont Ave Ste 901, Los Angeles, CA 90020-1912 | 2018-12-11 |
| 1609368323 | Los Angeles County Department of Mental Health | Clinic/Center | 780 N San Vicente Blvd Rm 217, West Hollywood, CA 90069-5021 | 2018-05-30 |
| 1033632468 | Los Angeles County Department of Mental Health | Clinic/Center | 1 W Manchester Blvd, Inglewood, CA 90301-1764 | 2017-07-18 |
| 1265955694 | Los Angeles County Department of Mental Health | Clinic/Center | 200 N Pacific Coast Hwy, Redondo Beach, CA 90277-3150 | 2017-07-18 |
| Street Address |
12021 WILMINGTON AVE |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90059 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750351300 | Gangadarshni Chandramohan | Pediatrics | 12021 Wilmington Ave, Los Angeles, CA 90059-3019 | 2006-01-25 |
| 1639704323 | Martin Luther King Jr Community Medical Group-wilmington Ave | Case Manager/Care Coordinator | 12021 Wilmington Ave, Building 11, Suite 1000, Los Angeles, CA 90059 | 2020-03-03 |
| 1114418928 | Exodus Recovery, Inc. | Community/Behavioral Health | 12021 Wilmington Ave, Los Angeles, CA 90059-3019 | 2018-05-29 |
| 1053855064 | Maria Casarez-romero | Rehabilitation Practitioner | 12021 Wilmington Ave, Los Angeles, CA 90059-3019 | 2016-12-09 |
| 1295279453 | Kelsey Collins | Marriage & Family Therapist | 12021 Wilmington Ave, Los Angeles, CA 90059-3019 | 2016-12-07 |
| 1639628035 | Stella Cuomo | Student in an Organized Health Care Education/Training Program | 12021 Wilmington Ave, Los Angeles, CA 90059-3019 | 2016-09-26 |
| 1821443995 | Patanya Matthews | Counselor | 12021 Wilmington Ave, Los Angeles, CA 90059-3019 | 2016-04-26 |
| 1043677289 | Kita Stovall | Nurse Practitioner | 12021 Wilmington Ave, Los Angeles, CA 90059 | 2016-01-19 |
| 1417314741 | Noele Le Flore | Nurse Practitioner | 12021 Wilmington Ave, Los Angeles, CA 90059-3019 | 2016-01-18 |
| 1659757672 | Sharon Vaughn | Social Worker | 12021 Wilmington Ave, Los Angeles, CA 90059-3019 | 2015-07-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235759788 | Juan Jimenez Jr. | Technician, Pathology | 1860 E 120th St, Los Angeles, CA 90059 | 2020-04-24 |
| 1538717780 | Donald O Nwanze | Pharmacist | Mlk Outpatient Center (pharmacy), 1670 East 120th Street, Los Angeles, CA 90059 | 2019-08-30 |
| 1295391050 | Sheela Hoyle | Counselor | 836 East Saucer Lane, Los Angeles, CA 90059 | 2019-05-16 |
| 1750852471 | Carlos Tovar Sr. | Community Health Worker | 1720 E 120st, Los Angeles, CA 90059 | 2018-12-06 |
| 1699293910 | Amy Caryn Bolenbaugh | Recreation Therapist | 1720 E 120th Street, Los Angeles, CA 90059 | 2017-09-07 |
| 1417475757 | Scott Lee Jones | Recreation Therapist | Augustus F. Hawkins, 1720 E. 120th Street, Rm. 2196, Los Angeles, CA 90059 | 2017-09-07 |
| 1881118859 | Darlene Renee Tillman | Speech-Language Pathologist | 1670 E 120th Strret, Los Angeles, CA 90059 | 2017-08-01 |
| 1609306430 | Valda Therese Flores | Registered Nurse | 1670 E. 120th Street, Los Angeles, CA 90059 | 2017-06-14 |
| 1093244006 | Bongsill Chung | Registered Nurse | 1670 East 120th St, Los Angeles, CA 90059 | 2017-06-05 |
| 1730573395 | Apollonia Godoy | Registered Nurse | 1670 E. 120th St, 4th Floor, Module A, Los Angeles, CA 90059 | 2015-03-22 |
| Find all providers in zip 90059 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023633864 | Andrea Forcina | Clinic/Center | 3401 Glendale Blvd Fl 2, Los Angeles, CA 90039-1814 | 2020-06-08 |
| 1831710706 | Beyond Cancer Family Therapy Inc | Clinic/Center | 4082 S Cloverdale Ave, Los Angeles, CA 90008-1033 | 2020-05-02 |
| 1518599851 | Vip Community Mental Health Center, Inc | Clinic/Center | 2820 E 1st St, Los Angeles, CA 90033-3636 | 2020-02-05 |
| 1699306340 | Vip Community Mental Health Center, Inc. | Clinic/Center | 2730 Ganahl St, Los Angeles, CA 90033-2019 | 2020-01-31 |
| 1629618350 | Ustawi | Clinic/Center | 13101 W Washington Blvd Ste 118, Los Angeles, CA 90066-5176 | 2020-01-10 |
| 1073158622 | Los Angeles County Department of Mental Health | Clinic/Center | 3303 N. Broadway Ave., 3rd/4th Floor, Los Angeles, CA 90031-0061 | 2019-11-07 |
| 1790327179 | Otc LLC | Clinic/Center | 6607 N Figueroa St Apt 10, Los Angeles, CA 90042-2037 | 2019-10-17 |
| 1144787961 | Los Angeles County Department of Mental Health | Clinic/Center | 813 E 4th Pl, Los Angeles, CA 90013-1805 | 2019-02-28 |
| 1427515246 | Los Angeles County Department of Mental Health | Clinic/Center | 11110 W Pico Blvd, Los Angeles, CA 90064-1709 | 2019-02-28 |
| 1295290658 | Thrive Therapy, Inc. | Clinic/Center | 12240 Venice Blvd Ste 26, Los Angeles, CA 90066-3891 | 2019-02-09 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90059 |
Please comment or provide details below to improve the information on LOS ANGELES COUNTY DEPARTMENT OF MENTAL HEALTH.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.