NORTHEAST VALLEY HEALTH CORPORATION
NPI 1114104015
Clinic/Center - Federally Qualified Health Center (FQHC) in Van Nuys, CA

Q: What is Northeast Valley Health Corporation's NPI number?

The NPI number for Northeast Valley Health Corporation is 1114104015. It was assigned to this organization in the NPPES registry on January 23, 2008.

Q: What is Northeast Valley Health Corporation's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

Active since January 23, 2008CLIA 05D0925503 · Microscopy

14624 SHERMAN WAY FL 6, VAN NUYS, CA 91405(818) 988-6335(818) 988-2140 Get Directions Write a Review

NPPES record last updated: February 22, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Feb 22, 2022, Jun 13, 2019 (2 updates tracked since 2019).

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About Northeast Valley Health Corporation NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NORTHEAST VALLEY HEALTH CORPORATION (NPI 1114104015) is a healthcare organization registered as a federally qualified health center (fqhc) in Van Nuys, California and active in the NPI registry since January 2008. The organization holds a CLIA Microscopy certificate valid through February 26, 2027 and lists Kimberly Wyard, Chief Executive Officer, as its authorized official.

NPPES Registry Identity

NPI1114104015

Entity TypeOrganization

Primary Taxonomy261QF0400X

Legal Business NameNORTHEAST VALLEY HEALTH CORPORATION

Location Address14624 SHERMAN WAY FL 6Van Nuys, CA 91405-2241

Mailing Address1172 N. Maclay Ave.San Fernando, CA 91340 · (818) 898-1388 · Fax (818) 365-4031

Phone(818) 988-6335

Fax(818) 988-2140

Organization SubpartNo

Authorized OfficialKimberly WyardChief Executive Officer · (818) 898-1388

Enumeration DateJanuary 23, 2008

Last NPPES UpdateFebruary 22, 20222 updates tracked since enumeration

NPPES CertifiedFebruary 22, 2022

✔ NPI 1114104015 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities

Taxonomy Code261QF0400X

Also ListedCase Manager/Care CoordinatorTaxonomy 171M00000X

Also ListedClinic/Center · Family Planning, Non-SurgicalTaxonomy 261QF0050X · License 960000947 (CA)

14624 SHERMAN WAY FL 6, Van Nuys, CA 91405

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Other Identifiers 1

OtherHAP70682FCA · Family Pact

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 05D0925503

Northeast Valley Health Corporation- Van Nuys Adult Health Center · Van Nuys, CA

Active · expires Feb 26, 2027

CLIA Number05D0925503

Laboratory TypeCommunity Clinic

Certificate Effective DateFebruary 27, 2025

Certificate Expiration DateFebruary 26, 2027

Laboratory DirectorJesse Sanders

Laboratory Phone(818) 988-6335

Laboratory LocationNortheast Valley Health Corporation- Van Nuys Adult Health Center14624 Sherman Way, Van Nuys, CA 91401

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Northeast Valley Health Corporation's NPI number?

The NPI number for Northeast Valley Health Corporation is 1114104015. It was assigned to this organization in the NPPES registry on January 23, 2008.

Where is Northeast Valley Health Corporation located?

Northeast Valley Health Corporation is located at 14624 Sherman Way Fl 6, Van Nuys, CA 91405. The listed phone number is (818) 988-6335.

What is Northeast Valley Health Corporation's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

Does Northeast Valley Health Corporation hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 05D0925503) is associated with this NPI, valid through February 26, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Northeast Valley Health Corporation was last updated on February 22, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.