NORTHEAST VALLEY HEALTH CORPORATION (NPI# 1760669667) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760669667 |
| Entity Type | Organization |
| Organization Name | NORTHEAST VALLEY HEALTH CORPORATION |
| Practice Address |
23763 Valnecia Blvd. Valencia CA 91355 |
| Mailing Address |
1172 N. Maclay Ave. San Fernando CA 91340 |
| Practice Telephone | 6612871551 |
| Practice Fax Number | 6612558037 |
| Mailing Telephone | 8188981388 |
| Mailing Fax Number | 8183654031 |
| Enumeration Date | 2008-01-23 |
| 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 | 261QF0050X |
Clinic/Center Specialization: Family Planning, Non-Surgical |
960000964 | CA | Ambulatory Health Care Facilities |
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | FAMILY PACT | HAP70650F | 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 |
| 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 |
| 1417958943 | Northeast Valley Health Corporation | Clinic/Center | 11051 N. O'melveny Ave, San Fernando, CA 91340-4426 | 2005-08-09 |
| Street Address |
23763 VALNECIA BLVD. |
| City | VALENCIA |
| State | CA |
| Zip Code | 91355 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447874730 | Deborah Colleen Rheinfurth | Registered Nurse | 25727 Mcbean Parkway, Valencia, CA 91355 | 2020-06-02 |
| 1396368106 | Carla Patricia Ponce | Behavior Technician | 25115 W, Avenue Stanford Suite A100, Santa Clarita, CA 91355 | 2020-05-27 |
| 1578197661 | Kathleen Megan Murphy Cross | Counselor | 24307 Magic Mountain Pkwy, #260, Valencia, CA 91355 | 2020-02-27 |
| 1780226340 | Logan Veis | Behavior Technician | 25515 Avenue Stanford, Suite A100, Valencia, CA 91355 | 2019-10-15 |
| 1376192906 | Yosef Desta | Behavior Technician | 25115 Ave Standard, Suit A100, Valencia, CA 91355 | 2019-09-06 |
| 1063060960 | Michauni Kimbrew | Behavioral Analyst | 27502 Ave Scott, Ste A, Santa Clarita, CA 91355 | 2019-09-04 |
| 1427607357 | Alissa Meadow Myatt | Social Worker | Henry Mayo Newhall Hospital 23845 Mcbean Parkway, Valencia, CA 91355 | 2019-09-04 |
| 1124672761 | Genon Catarroja | Behavior Technician | 25115 W. Avenue Stanford Suite A100, Valencia, CA 91355 | 2019-08-01 |
| 1730675455 | Jaquelyn Marlene Escobar | Community Health Worker | 24525 Town Center Drive, Valencia, CA 91355 | 2018-07-05 |
| 1265922843 | Jomil Prenzirose Conste | Behavior Technician | 25115 Avenue M14 Suite A, Valencia, CA 91355 | 2018-05-18 |
| Find all providers in zip 91355 | ||||
| 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 |
|---|---|---|---|---|
| 1851578751 | Northeast Valley Health Corporation | Clinic/Center | 23763 Valencia Blvd., Valencia, CA 91355 | 2008-01-23 |
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| 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.