NORTHEAST VALLEY HEALTH CORPORATION (NPI# 1346427366) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346427366 |
| Entity Type | Organization |
| Organization Name | NORTHEAST VALLEY HEALTH CORPORATION |
| Practice Address |
1600 San Fernando Road San Fernando CA 91340 |
| Mailing Address |
1172 N. Maclay Ave. San Fernando CA 91340 |
| Practice Telephone | 8183658086 |
| Practice Fax Number | 8188984826 |
| Mailing Telephone | 8188981388 |
| Mailing Fax Number | 8183654031 |
| Enumeration Date | 2008-01-22 |
| Last Update Date | 2019-06-13 |
| Authorized Official Name | MRS. KIMBERLY WYARD (CHEIF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 8188981388 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities | ||
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
960000124 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | CANCER DETECTION PROGRAM | BCP11580F | 01 |
| 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 |
| 1154322642 | Northeast Valley Health Corporation | Clinic/Center | 13356 Eldridge Ave, Sylmar, CA 91342-3200 | 2005-08-09 |
| 1053312587 | Northeast Valley Health Corporation | Clinic/Center | 12451 W. Gain Street, Pacoima, CA 91331 | 2005-08-09 |
| Street Address |
1600 SAN FERNANDO ROAD |
| City | SAN FERNANDO |
| State | CA |
| Zip Code | 91340 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245232644 | Rowena Reyes Alcantara-fernandez | Nurse Practitioner | 1600 San Fernando Road, San Fernando, CA 91340-1300 | 2005-08-15 |
| 1063699080 | Northeast Valley Health Corporation | Clinic/Center | 1600 San Fernando Road, San Fernando, CA 91340 | 2008-01-22 |
| 1689791139 | Michael S. Wallack | Internal Medicine | 1600 San Fernando Road, San Fernando, CA 91340 | 2007-03-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043844301 | Atalla Dental Corp. | Clinic/Center | 557 N. Maclay Ave., San Fernando, CA 91340 | 2020-02-26 |
| 1235623190 | Kohan & Rodef Dental Corporation | Dentist | 500 San Fernardo Mission Blvd Suite #2, San Fernardo, CA 91340 | 2018-06-14 |
| 1700388766 | North Valley Diagnostics Services, Inc. | Electrodiagnostic Medicine | 670 San Fernando Mission Blvd, #d, San Fernando, CA 91340 | 2018-03-06 |
| 1750889531 | Garfield Beach Cvs, L.l.c | Durable Medical Equipment & Medical Supplies | 1204 San Fernando Rd, San Fernando, CA 91340 | 2018-01-26 |
| 1689118598 | Maira Yesenia Lopez | Counselor | 565 S. Brand Blvd, San Fernando, CA 91340 | 2016-12-12 |
| 1386042166 | Afsaneh Mazaheri-sichani | Dentist | 777 Turman St., Suite 107, San Fernando, CA 91340 | 2014-12-11 |
| 1396154167 | Lorena Tercero | Marriage & Family Therapist | 302 S. Brand Blvd, San Fernando, CA 91340 | 2014-08-06 |
| 1689082836 | Germine Aznavour | Pharmacist | 12920 Foothill Blvd, San Fernando, CA 91340 | 2014-07-31 |
| 1841605151 | Aswani Dental Corporation | Clinic/Center | 12940 Foothill Blvd Ste C, San Fernando, CA 91340 | 2014-06-25 |
| 1467705624 | Brenda Lira | Social Worker | 11565 Laurel Canyon Blvd., Suite 116, San Fernando, CA 91340 | 2012-10-24 |
| Find all providers in zip 91340 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
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| Find all providers with the same taxonomy | ||||
| City | SAN FERNANDO |
| Zip Code | 91340 |
Please comment or provide details below to improve the information on NORTHEAST VALLEY HEALTH CORPORATION.
| 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.