NORTHEAST VALLEY HEALTH CORPORATION (NPI# 1417958943) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417958943 |
| Entity Type | Organization |
| Organization Name | NORTHEAST VALLEY HEALTH CORPORATION |
| Other Organization Name | SAN FERNANDO HIGH SCHOOL TEEN HEALTH CENTER |
| Practice Address |
11051 N. O'melveny Ave San Fernando CA 91340-4426 |
| Mailing Address |
1172 N Maclay Ave San Fernando CA 91340-1328 |
| Practice Telephone | 8183657517 |
| Practice Fax Number | 8188376342 |
| Mailing Telephone | 8188981388 |
| Mailing Fax Number | 8182709585 |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2019-06-13 |
| 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 |
|---|---|---|---|---|---|
| N | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities | ||
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| San Fernando High School Teen 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 |
| 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 |
11051 N. O'MELVENY AVE |
| City | SAN FERNANDO |
| State | CA |
| Zip Code | 91340-4426 |
| 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 | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740437961 | Northeast Valley Health Corporation | Clinic/Center | 1172 N. Maclay Ave., San Fernando, CA 91340-1300 | 2008-08-19 |
| 1063699080 | Northeast Valley Health Corporation | Clinic/Center | 1600 San Fernando Road, San Fernando, CA 91340 | 2008-01-22 |
| 1346427366 | Northeast Valley Health Corporation | Clinic/Center | 1600 San Fernando Road, San Fernando, CA 91340 | 2008-01-22 |
| 1154510139 | Northeast Valley Health Corporation | Clinic/Center | 1172 N Maclay Ave, San Fernando, CA 91340-1328 | 2007-10-16 |
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| Find all providers with the same taxonomy | ||||
| City | SAN FERNANDO |
| Zip Code | 91340 |
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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.