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Organization
LAUSD 97TH ST SMH CLINIC
Active
Organization
LAUSD 97TH ST SMH CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PIA ESCUDERO (DIRECTOR)
(213) 241-3841
Entity
Organization
Contact information
Practice address
439 W 97TH ST, LOS ANGELES, CA 90003-3968
(323) 754-2856
(323) 754-1843
Mailing address
333 S BEAUDRY AVE, LOS ANGELES, CA 90017-1466
(213) 241-3841
(213) 241-3305
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
1041C0700X
Clinical Social Worker
Primary
0315
CA
163WP0808X
Psychiatric/Mental Health Registered Nurse
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0315
LA CTY ENTITY
CA
Enumeration date
06/25/2009
Last updated
06/25/2009
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