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JHA GERIATRIC SERVICES NPI 1811990377


NPI Information

NPI: 1811990377
Provider Name: JHA GERIATRIC SERVICES

Other Name: GRANCELL VILLAGE CLINIC

Classification: Clinic/Center - 261Q00000X
Entity Type: Organization
Address:
7150 TAMPA AVE
RESEDA, CA
ZIP 91335
Phone: (818) 774-3000
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JHA GERIATRIC SERVICES is a clinic center in Reseda, CA. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). JHA GERIATRIC SERVICES NPI is 1811990377. The provider is registered as an organization entity type.
The provider Other Name Is Grancell Village Clinic.

The provider's business location address is:

7150 TAMPA AVE
RESEDA, CA
ZIP 91335
Phone: (818) 774-3000

The provider's authorized official is Mary M Forrest .
The authorized official title is Chief Executive Officer and has the following contact phone number (818) 774-3208.

The enumeration date for this NPI number is 5/27/2005 and was last updated on 7/2/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261Q00000XClinic/Center960000819CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1CMM70542FMEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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