NORTHEAST VALLEY HEALTH CORPORATION – NPI #1013199264
Clinic/Center

NORTHEAST VALLEY HEALTH CORPORATION is an AHC clinic located in SUN VALLEY, CA. NPPES has assigned the NPI number 1013199264 to NORTHEAST VALLEY HEALTH CORPORATION on November 29, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 261QF0400X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Federally Qualified Health Center (FQHC)

The NPI profile was previously updated about 4 years ago on Feb 22, 2022. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for NORTHEAST VALLEY HEALTH CORPORATION below.

NPI Profile for
NORTHEAST VALLEY HEALTH CORPORATION

NPI Number
1013199264
Enumeration Date

(more than 18 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
NORTHEAST VALLEY HEALTH CORPORATION
Primary location
7223 N. FAIR AVENUE
SUN VALLEY, CA 91352
Phone: (818) 432-4400 Fax: (818) 764-7930
Mailing address
1172 N MACLAY AVE
SAN FERNANDO, CA 91340-1328
Phone: (818) 898-1388 Fax: (818) 365-4031
Organization Subpart
No
Authorized Official
KIMBERLY WYARD
CHIEF EXECUTIVE OFFICER
Phone: (818) 898-1388
Updated
Certification Date
Feb 22, 2022

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for NORTHEAST VALLEY HEALTH CORPORATION

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
OTHERMEDICARE PROVIDER #CA05-1137
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QF0400X
- Clinic/Center / Federally Qualified Health Center (FQHC) (Primary)
171M00000X
- Case Manager/Care Coordinator

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.