SAN FERNANDO HIGH SCHOOL TEEN HEALTH CENTER
NPI 1417958943
Clinic/Center - Federally Qualified Health Center (FQHC) in San Fernando, CA

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

The NPI number for Northeast Valley Health Corporation is 1417958943. It was assigned to this organization in the NPPES registry on August 9, 2005. The provider is doing business as San Fernando High School Teen 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, 2005CLIA 05D0683657 · Microscopy

11051 N. O'MELVENY AVE, SAN FERNANDO, CA 91340(818) 365-7517(818) 837-6342 Get Directions Write a Review

NPPES record last updated: February 23, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Feb 23, 2022, Jun 13, 2019 (2 updates tracked since 2019).

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About San Fernando High School Teen Health Center NPPES

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

SAN FERNANDO HIGH SCHOOL TEEN HEALTH CENTER (NPI 1417958943) is a healthcare organization registered as a federally qualified health center (fqhc) in San Fernando, 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

NPI1417958943

Entity TypeOrganization

Primary Taxonomy261QF0400X

Legal Business NameNORTHEAST VALLEY HEALTH CORPORATION

Location Address11051 N. O'MELVENY AVESan Fernando, CA 91340-4426

Mailing Address1172 N Maclay AveSan Fernando, CA 91340-1328 · (818) 898-1388 · Fax (818) 270-9585

Phone(818) 365-7517

Fax(818) 837-6342

Organization SubpartNo

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

Enumeration DateAugust 9, 2005

Last NPPES UpdateFebruary 23, 20222 updates tracked since enumeration

NPPES CertifiedFebruary 23, 2022

✔ NPI 1417958943 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 · DentalTaxonomy 261QD0000X

11051 N. O'MELVENY AVE, San Fernando, CA 91340

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Other Names 1

Doing Business AsSan Fernando High School Teen Health Center

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) 05D0683657

Northeast Valley Health Corporation- School Base Clinic · San Fernando, CA

Active · expires Aug 31, 2026

CLIA Number05D0683657

Laboratory TypeCommunity Clinic

Certificate Effective DateSeptember 1, 2024

Certificate Expiration DateAugust 31, 2026

Laboratory DirectorMartin Anderson

Laboratory Phone(818) 365-7517

Laboratory LocationNortheast Valley Health Corporation- School Base Clinic11051 N O'melveny Ave, San Fernando, CA 91340

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 1417958943. It was assigned to this organization in the NPPES registry on August 9, 2005. The provider is doing business as San Fernando High School Teen Health Center.

Where is Northeast Valley Health Corporation located?

Northeast Valley Health Corporation is located at 11051 N. O'melveny Ave, San Fernando, CA 91340. The listed phone number is (818) 365-7517.

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 05D0683657) 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 23, 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.