Organization
CALIFORNIA STATE UNIVERSITY, NORTHRIDGE
Active
Other names
Klotz Student Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. 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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
EXE70150F
MEDI-CAL PROVIDER
CA
Enumeration date
02/07/2007
Last updated
12/23/2009
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