Organization
LOS ANGELES UNIFIED SCHOOL DISTRICT
Active
Other names
LAUSD 97th Street School MH Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN DICECCO (DIRECTOR)
(213) 241-3846
Entity
Organization
Contact information
Practice address
439 W 97TH ST, LOS ANGELES, CA 90003-3968
(213) 241-0558
(213) 241-8458
Mailing address
333 S BEAUDRY AVE, SHHS - COST RECOVERY 29-216-02, LOS ANGELES, CA 90017-1466
(213) 241-0558
(213) 241-8458
Taxonomy
Speciality
Code
Description
License number
State
101YS0200X
School Counselor
SS1964733
CA
103TS0200X
School Psychologist
SS1964733
CA
1041S0200X
School Social Worker
SS1964733
CA
1041S0200X
School Social Worker
Primary
—
CA
163WS0200X
School Registered Nurse
SS1964733
CA
208000000X
Pediatrics Physician
SS1964733
CA
225100000X
Physical Therapist
SS1964733
CA
225X00000X
Occupational Therapist
SS1964733
CA
231H00000X
Audiologist
SS1964733
CA
235Z00000X
Speech-Language Pathologist
SS1964733
CA
251300000X
Local Education Agency (LEA)
SS1964733
CA
251K00000X
Public Health or Welfare Agency
SS1964733
CA
251S00000X
Community/Behavioral Health Agency
0315
CA
363LS0200X
School Nurse Practitioner
SS1964733
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0315
—
CA
05
—
SS1964733
—
CA
Enumeration date
06/30/2005
Last updated
11/06/2012
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