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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