1. Home
  2. Directory
  3. California
  4. Pacoima
  5. Clinic Center
  6. NPI Profile

PACOIMA HEALTH CENTER
NPI 1114928595
Clinic/Center - Federally Qualified Health Center (FQHC) in Pacoima, CA

Active since August 09, 2005CLIA 05D0666584 · Microscopy
12756 VAN NUYS BLVD, PACOIMA, CA 91331(818) 896-0531(818) 896-5850 Get Directions Write a Review

NPPES record last updated: February 22, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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

About Pacoima Health Center NPPES

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

PACOIMA HEALTH CENTER (NPI 1114928595) is a healthcare organization registered as a federally qualified health center (fqhc) in Pacoima, California and active in the NPI registry since August 2005. The organization holds a CLIA Microscopy certificate valid through August 31, 2026 and lists Kimberly Wyard, Chief Executive Officer, as its authorized official.

NPPES Registry Identity

NPI1114928595
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameNORTHEAST VALLEY HEALTH CORPORATION
Location Address12756 VAN NUYS BLVDPacoima, CA 91331-1626
Mailing Address1172 N Maclay AveSan Fernando, CA 91340-1328 · (818) 898-1388 · Fax (818) 365-4031
Phone(818) 896-0531
Fax(818) 896-5850
Organization SubpartNo
Authorized OfficialKimberly WyardChief Executive Officer · (818) 898-1388
Enumeration DateAugust 9, 2005
Last NPPES UpdateFebruary 22, 20222 updates tracked since enumeration
NPPES CertifiedFebruary 22, 2022
✔ NPI 1114928595 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 · Community HealthTaxonomy 261QC1500X · License 9600189 (CA)
12756 VAN NUYS BLVD, Pacoima, CA 91331
Open in Google Maps ↗

Other Names 1

Doing Business AsPacoima Health Center

Other Identifiers 1

OtherW14819AMin

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) 05D0666584

Pacoima Health Center · Pacoima, CA
Active · expires Aug 31, 2026
CLIA Number05D0666584
Laboratory TypeCommunity Clinic
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorGina Johnson
Laboratory Phone(818) 896-0531
Laboratory LocationPacoima Health Center12756 Van Nuys Boulevard, Pacoima, CA 91331
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.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JENNY L. YOON NP
Nurse Practitioner (Pediatrics)
12756 VAN NUYS BLVD
PACOIMA, CA 91331
Los Angeles County (818) 896-0531
MS. CAROLINA HERRERA RDN
Dietitian, Registered
12756 VAN NUYS BLVD
PACOIMA, CA 91331
Los Angeles County (818) 896-0531
MS. LATONYA BURNELL N.P.
Nurse Practitioner (Obstetrics & Gynecology)
12756 VAN NUYS BLVD
PACOIMA, CA 91331
Los Angeles County (818) 896-0531
NAVEEN KUMAR DHIMAN M.D.
Family Medicine
12756 VAN NUYS BLVD
PACOIMA, CA 91331
Los Angeles County (818) 896-0531
MRS. URMILA (UMI) MUKHERJEE RNP/CNM
Nurse Practitioner (Obstetrics & Gynecology)
12756 VAN NUYS BLVD
PACOIMA, CA 91331
Los Angeles County (818) 896-0531
MRS. DIANA PEREZ NUNEZ NURSE PRACTITIONER
Nurse Practitioner (Obstetrics & Gynecology)
12756 VAN NUYS BLVD
PACOIMA, CA 91331
Los Angeles County (818) 896-0531
CRISTINA L. VIGIL SOCIAL WORKER
Social Worker
12756 VAN NUYS BLVD
PACOIMA, CA 91331
Los Angeles County (818) 896-0531
JESSE DAVID SANDERS JR. M.D.
Family Medicine
12756 VAN NUYS BLVD
PACOIMA, CA 91331
Los Angeles County (818) 896-0531

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 1114928595. It was assigned to this organization in the NPPES registry on August 9, 2005. The provider is doing business as Pacoima Health Center.

Where is Northeast Valley Health Corporation located?

Northeast Valley Health Corporation is located at 12756 Van Nuys Blvd, Pacoima, CA 91331. The listed phone number is (818) 896-0531.

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 05D0666584) is associated with this NPI, valid through August 31, 2026. 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.