Provider Demographics
NPI:1043461072
Name:LOS ANGELES COUNTY PROBATION DEPARTMENT
Entity type:Organization
Organization Name:LOS ANGELES COUNTY PROBATION DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROBATION OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DERRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:HARVEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-575-4204
Mailing Address - Street 1:9150 IMPERIAL HWY RM P-31
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90242-2835
Mailing Address - Country:US
Mailing Address - Phone:562-940-3694
Mailing Address - Fax:
Practice Address - Street 1:11234 VALLEY BLVD STE 302
Practice Address - Street 2:
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91731-3241
Practice Address - Country:US
Practice Address - Phone:626-575-4204
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-08
Last Update Date:2008-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management