Organization
NORTHEAST VALLEY HEALTH CORPORATION
Active
Other names
Transitions to Wellness-Van Nuys 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
6551 VAN NUYS BLVD FL 2, VAN NUYS, CA 91401-1566
(818) 765-8656
(818) 765-6982
Mailing address
1172 N MACLAY AVE, SAN FERNANDO, CA 91340-1328
(818) 898-1388
(818) 270-9585
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05-1086
MEDICARE PART A
CA
01
—
CB204579
MEDICARE PART B
CA
01
—
FHC70582F
MEDI-CAL
CA
01
—
W14819D
MIN
—
Enumeration date
08/09/2005
Last updated
02/22/2022
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us