Organization
NORTHEAST VALLEY HEALTH CORPORATION
Active
Other names
L.A. MISSION COLLEGE STUDENT HEALTH CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIMBERLY WYARD (CHIEF EXECUTIVE OFFICER)
(818) 898-1388
Entity
Organization
Contact information
Practice address
13356 ELDRIDGE AVE, SYLMAR, CA 91342-3200
(818) 362-6182
(818) 367-2340
Mailing address
1172 N MACLAY AVE, SAN FERNANDO, CA 91340-1328
(818) 898-1388
(818) 365-4031
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
08/09/2005
Last updated
02/22/2022
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