Northeast Valley Health Corporation
Clinic/Center, Family Planning, Non-Surgical in San Fernando, CA. Organization (NPI-2).
NPI number1063699080
StatusActive
Last updated in NPPESFeb 22, 2022
Details
- NPI
- 1063699080
- Entity type
- Organization (NPI-2)
- Legal business name
- Northeast Valley Health Corporation
- Organization subpart
- No
- Enumeration date
- Jan 22, 2008
- Certification date
- Feb 22, 2022
- Last updated
- Feb 22, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QF0050X | Clinic/Center, Family Planning, Non-Surgical | 960000124 | CA | Yes |
| 261QF0400X | Clinic/Center, Federally Qualified Health Center (FQHC) | – | – | |
| 171M00000X | Case Manager/Care Coordinator | – | – |
Practice location
1600 San Fernando RoadSan Fernando, CA 91340
Phone 818-365-8086 · Fax 818-898-4826
Mailing address
1172 N. Maclay Ave.San Fernando, CA 91340
Phone 818-898-1388 · Fax 818-365-4031
Authorized official
Kimberly Wyard
Chief Executive Officer
8188981388
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