NORTHEAST VALLEY HEALTH CORPORATION (NPI# 1154322642) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1154322642 |
Entity Type | Organization |
Organization Name | NORTHEAST VALLEY HEALTH CORPORATION |
Other Organization Name | L.A. MISSION COLLEGE STUDENT HEALTH CENTER |
Practice Address |
13356 Eldridge Ave Sylmar CA 91342-3200 |
Mailing Address |
1172 N Maclay Ave San Fernando CA 91340-1328 |
Practice Telephone | 8183626182 |
Practice Fax Number | 8183672340 |
Mailing Telephone | 8188981388 |
Mailing Fax Number | 8183654031 |
Enumeration Date | 2005-08-09 |
Last Update Date | 2019-06-14 |
Authorized Official Name | MRS. KIMBERLY WYARD (CHIEF EXECUTIVE OFFICER) |
Authorized Official Telephone | 8188981388 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
Other Name | Type Code |
---|---|
L.A. MISSION COLLEGE STUDENT HEALTH CENTER | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1801399860 | Northeast Valley Health Corporation | Clinic/Center | 12759 Van Nuys Blvd, Pacoima, CA 91331-1627 | 2018-03-15 |
1740437961 | Northeast Valley Health Corporation | Clinic/Center | 1172 N. Maclay Ave., San Fernando, CA 91340-1300 | 2008-08-19 |
1881871721 | Northeast Valley Health Corporation | Clinic/Center | 13356 Eldridge Ave., Sylmar, CA 91342 | 2008-01-23 |
1760669667 | Northeast Valley Health Corporation | Clinic/Center | 23763 Valnecia Blvd., Valencia, CA 91355 | 2008-01-23 |
1114104015 | Northeast Valley Health Corporation | Clinic/Center | 14624 Sherman Way Fl 6, Van Nuys, CA 91405-2241 | 2008-01-23 |
1841477742 | Northeast Valley Health Corporation | Clinic/Center | 11051 N. O'melveny Avenue, San Fernando, CA 91340-4426 | 2008-01-23 |
1356528376 | Northeast Valley Health Corporation | Clinic/Center | 12756 Van Nuys Boulevard, Pacoima, CA 91331 | 2008-01-22 |
1013199264 | Northeast Valley Health Corporation | Clinic/Center | 7223 N. Fair Avenue, Sun Valley, CA 91352 | 2007-11-29 |
1053312587 | Northeast Valley Health Corporation | Clinic/Center | 12451 W. Gain Street, Pacoima, CA 91331 | 2005-08-09 |
1417958943 | Northeast Valley Health Corporation | Clinic/Center | 11051 N. O'melveny Ave, San Fernando, CA 91340-4426 | 2005-08-09 |
Street Address |
13356 ELDRIDGE AVE |
City | SYLMAR |
State | CA |
Zip Code | 91342-3200 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619210374 | Timothy L Gilmore I | Psychologist | 13356 Eldridge Ave, Sylmar, CA 91342-3200 | 2013-04-01 |
1043439987 | Tresha San-martin | Specialist/Technologist | 13356 Eldridge Ave, Sylmar, CA 91342-3200 | 2007-04-25 |
1154441731 | Ieda Andal | Physician Assistant | 13356 Eldridge Ave, Sylmar, CA 91342-3200 | 2007-03-29 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1629687223 | Evelyn Pinto Morales | Technician, Other | 14445 Olive View Dr, Sylmar, CA 91342 | 2020-07-29 |
1528520988 | Yeun Lim | Student in an Organized Health Care Education/Training Program | 14445 Olive View Dr., Cottage H1, Attn D. Ray, Sylmar, CA 91342 | 2019-04-04 |
1467914317 | Sevak Hovagimyan | Pharmacist | 13677 Foothill Blvd #b, Sylmar, CA 91342 | 2019-04-01 |
1619455086 | Cameda Trichele Dickerson | Counselor | Phoenix House 116600 Eldridge, Lake View Terrace, CA 91342 | 2018-07-30 |
1407349624 | Joseph Sungkon Choi | Acupuncturist | 10274 Foothill Blvd, Sylmar, CA 91342 | 2018-06-12 |
1780194522 | Joe Anthony Cardenas | Specialist/Technologist | 15450 Roxford Street, Sylmar, CA 91342 | 2017-10-06 |
1336668466 | Juan Hernandez | Chiropractor | 13950 Foothill Blvd Apt 108, Sylmar, CA 91342 | 2017-09-09 |
1891213492 | Richard Ignacio Martinez | Nurse Practitioner | 14987 Oro Grande St., Sylmar, CA 91342 | 2017-09-03 |
1104349497 | Vanessa Gamboa | Social Worker | 13145 Bromont Ave., 14, Sylmar, CA 91342 | 2017-07-19 |
1982138368 | Christina Guest | Psychiatry & Neurology | Olive View Medical Center, 14445 Olive View Drive, Sylmar, CA 91342 | 2017-04-12 |
Find all providers in zip 91342 |
Taxonomy Code | 261QF0400X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Federally Qualified Health Center (FQHC) |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1972005528 | Community Medical Wellness Centers Usa | Clinic/Center | 14117 Hubbard St Unit M, Sylmar, CA 91342-4765 | 2018-02-28 |
1881871721 | Northeast Valley Health Corporation | Clinic/Center | 13356 Eldridge Ave., Sylmar, CA 91342 | 2008-01-23 |
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1760098503 | Chicago Clinica Medica Familiar Operated By Neighborhood Healthcare | Clinic/Center | 4022 Chicago Ave Ste A, Riverside, CA 92507-5340 | 2020-09-17 |
1164037149 | Camarena Health | Clinic/Center | 16645 Road 26, Madera, CA 93638-0830 | 2020-09-15 |
Find all providers with the same taxonomy |
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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.