Provider Demographics
NPI:1720306988
Name:L.A. COUNTY PROBATION DEPT.
Entity type:Organization
Organization Name:L.A. COUNTY PROBATION DEPT.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISION DEPUTY PROBATION OFFICE
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:WONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-491-5884
Mailing Address - Street 1:415 W OCEAN BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90802-4512
Mailing Address - Country:US
Mailing Address - Phone:562-491-5834
Mailing Address - Fax:562-435-8523
Practice Address - Street 1:415 W OCEAN BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90802-4512
Practice Address - Country:US
Practice Address - Phone:562-491-5834
Practice Address - Fax:562-435-8523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-12
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management