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NORTHEAST VALLEY HEALTH CORPORATION NPI 1447437462


NPI Information

NPI: 1447437462
Provider Name: NORTHEAST VALLEY HEALTH CORPORATION
Classification: Clinic/Center - 261QM2500X
Entity Type: Organization

Specialization: Medical Specialty

Address:
12756 VAN NUYS BOULEVARD
PACOIMA, CA
ZIP 91331
Phone: (818) 896-0531
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NORTHEAST VALLEY HEALTH CORPORATION is a medical specialty clinic center in Pacoima, CA. The provider is 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). NORTHEAST VALLEY HEALTH CORPORATION NPI is 1447437462. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

12756 VAN NUYS BOULEVARD
PACOIMA, CA
ZIP 91331
Phone: (818) 896-0531
Fax: (818) 896-5850

The provider's authorized official is Kimberly Wyard .
The authorized official title is Chief Executive Officer and has the following contact phone number (818) 898-1388.

The enumeration date for this NPI number is 1/22/2008 and was last updated on 2/23/2022.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1171M00000XCase Manager/Care CoordinatorNo
2261QF0400XClinic/CenterFederally Qualified Health Center (FQHC)No
3261QM2500XClinic/CenterMedical Specialty960000189CALIFORNIAYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1BCP11838FOTHERCALIFORNIACANCER DETECTION PROGRAM

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: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.