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Organization
CALIFORNIA STATE UNIVERSITY, NORTHRIDGE, KLOTZ STUDENT HEALTH CENTER
Active
Organization
CALIFORNIA STATE UNIVERSITY, NORTHRIDGE, KLOTZ STUDENT HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. YOLANDA REID CHASSIAKOS M.D. (DIRECTOR, STUDENT HEALTH CENTER)
(818) 677-3666
Entity
Organization
Contact information
Practice address
18111 NORDHOFF ST, NORTHRIDGE, CA 91330-8270
(818) 677-3666
(818) 677-5225
Mailing address
18111 NORDHOFF ST, NORTHRIDGE, CA 91330-8270
(818) 677-3666
(818) 677-5225
Taxonomy
Speciality
Code
Description
License number
State
261QS1000X
Student Health Clinic/Center
Primary
GOVERNMENT ENTITY
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GR0094830
MEDI-CAL/FPACT
CA
Enumeration date
08/02/2006
Last updated
08/22/2020
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