SAN FERNANDO HIGH SCHOOL TEEN HEALTH CENTER
NPI 1417958943
Clinic/Center - Federally Qualified Health Center (FQHC) in San Fernando, CA
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, 2028 and lists Kimberly Wyard, Chief Executive Officer, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 3
Other Names 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
San Fernando High School Teen Health Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
217Medicare enrollment records show 217 clinicians reassign Medicare billing to San Fernando High School Teen Health Center, which bills Medicare for the services they deliver. Of these, 98 practice within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 15
Nearest to this location (20)
See all 217Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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, CAFrequently 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.
Is Northeast Valley Health Corporation enrolled in Medicare?
Yes. Northeast Valley Health Corporation is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Northeast Valley Health Corporation?
According to the CMS Revalidation Reassignment List (October 2026 release), 217 clinicians in 15 Medicare specialties reassign their Medicare billing to Northeast Valley Health Corporation. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (60), Pediatric Medicine (48) and Family Practice (28). Of these, 98 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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, 2028. 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.
# San Fernando High School Teen Health Center · NPI 1417958943
Federally Qualified Health Center (FQHC) organization in San Fernando, California. Organization record, active in the CMS NPPES registry since August 9, 2005.
## Identity
- **NPI:** 1417958943 (Entity type: Organization)
- **Enumerated:** August 9, 2005
- **Primary specialty:** Clinic/Center - Federally Qualified Health Center (FQHC) · taxonomy 261QF0400X
- **Legal business name:** Northeast Valley Health Corporation
- **Organization subpart:** No
- **Authorized official:** Kimberly Wyard, CHIEF EXECUTIVE OFFICER
## Practice location
- **Address:** 11051 N. O'MELVENY AVE, San Fernando, CA 91340-4426
- **Phone:** (818) 365-7517 · **Fax:** (818) 837-6342
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 217 clinicians in 15 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (60), Pediatric Medicine (48), Family Practice (28); 98 practice within 10 miles; [full list](https://npiprofile.com/npi/1417958943/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 23, 2022
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1417958943) · Data from the CMS NPPES public registry.