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

Q: 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.

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 August 09, 2005

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: September 13, 2026.

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

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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 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

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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

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)