PACIFICA HOSPITAL OF THE VALLEY
Complete NPI Record 1861402935
General Acute Care Hospital in Sun Valley, CA

Active since August 09, 2006
1/5
Hospital Overall Rating
9449 SAN FERNANDO ROAD, SUN VALLEY, CA 91352(818) 767-3310(818) 252-2291 Get Directions

NPPES record last updated: June 3, 2008. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Complete NPI Dataset

This page contains the complete raw NPPES record for Pacifica Hospital Of The Valley (NPI 1861402935), a general acute care hospital organization in Sun Valley, CA. All 74 fields on file are listed with their current values and official NPPES definitions, exactly as recorded in the National Plan and Provider Enumeration System. Only fields that contain data are included, so the number of fields shown varies from one NPI record to another.

Use the tools below to filter fields by category, search within the record, or jump straight to a specific field. You can download the full record as a CSV, JSON, or text file, or filter first and export only the fields you need. The Print Clean Summary button produces a printer-friendly copy of the record.

Registry File Document Utilities
NPI: 1861402935
Field 1/74
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 2
Field 2/74
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Employer Identification Number EIN: Not available
Field 3/74
The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
Provider Organization Name Legal Business Name: PACIFICA OF THE VALLEY CORPORATION
Field 4/74
The name of the organization provider. If the provider is an organization, this is the legal business name.
Provider Other Organization Name: PACIFICA HOSPITAL OF THE VALLEY
Field 5/74
Other name by which the organization provider is or has been known.
Provider Other Organization Name Type Code: 3
Field 6/74
Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
Provider First Line Business Mailing Address: 9449 SAN FERNANDO ROAD
Field 7/74
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Business Mailing Address City Name: SUN VALLEY
Field 8/74
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: CA
Field 9/74
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code: 91352
Field 10/74
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Country Code If outside U S : US
Field 11/74
The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
Provider Business Mailing Address Telephone Number: 8187673310
Field 12/74
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number: 8182522291
Field 13/74
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Provider First Line Business Practice Location Address: 9449 SAN FERNANDO ROAD
Field 14/74
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: SUN VALLEY
Field 15/74
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: CA
Field 16/74
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 91352
Field 17/74
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
Field 18/74
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 8187673310
Field 19/74
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number: 8182522291
Field 20/74
The fax number associated with the location address of the provider being identified.
Authorized Official Last Name: WATKINS
Field 23/74
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First Name: GEORGE
Field 24/74
The first name of the authorized official.
Authorized Official Title or Position: CFO
Field 25/74
The title or position of the authorized official.
Authorized Official Telephone Number: 8182522196
Field 26/74
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1: 282N00000X
Field 27/74
This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 1: 930000148
Field 28/74
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
Provider License Number State Code 1: CA
Field 29/74
The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
Healthcare Provider Primary Taxonomy Switch 1: Y
Field 30/74
This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
Other Provider Identifier 1: 9747230
Field 31/74
An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
Other Provider Identifier Type Code 1: 01
Field 32/74
A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
Other Provider Identifier Issuer 1: MEDI-CAL PROV ACUTE PIN
Field 33/74
The name of the organization, agency, or health plan that assigned the additional provider identifier. This identifies who issued the number linked to Other Provider Identifier 1 (for example, a state Medicaid agency, Medicare, or a private insurance company).
Other Provider Identifier 2: 9927230
Field 34/74
An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
Other Provider Identifier Type Code 2: 01
Field 35/74
A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
Other Provider Identifier Issuer 2: MEDI-CAL PROV OUTPATIENT
Field 36/74
The name of the organization, agency, or health plan that assigned the additional provider identifier. This identifies who issued the number linked to Other Provider Identifier 1 (for example, a state Medicaid agency, Medicare, or a private insurance company).
Other Provider Identifier 3: LTC55217G
Field 37/74
An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
Other Provider Identifier Type Code 3: 05
Field 38/74
A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
Other Provider Identifier State 3: CA
Field 39/74
The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
Other Provider Identifier 4: LTC70026G
Field 40/74
An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
Other Provider Identifier Type Code 4: 05
Field 41/74
A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
Other Provider Identifier State 4: CA
Field 42/74
The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
Other Provider Identifier 5: ZZT30378H
Field 43/74
An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
Other Provider Identifier Type Code 5: 05
Field 44/74
A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
Other Provider Identifier State 5: CA
Field 45/74
The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
Other Provider Identifier 6: ZZT40378H
Field 46/74
An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
Other Provider Identifier Type Code 6: 05
Field 47/74
A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
Other Provider Identifier State 6: CA
Field 48/74
The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
Other Provider Identifier 7: ZZA2008Z
Field 49/74
An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
Other Provider Identifier Type Code 7: 01
Field 50/74
A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
Other Provider Identifier Issuer 7: BLUE SHIELD PROVIDER
Field 51/74
The name of the organization, agency, or health plan that assigned the additional provider identifier. This identifies who issued the number linked to Other Provider Identifier 1 (for example, a state Medicaid agency, Medicare, or a private insurance company).
Other Provider Identifier 8: 2887230
Field 52/74
An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
Other Provider Identifier Type Code 8: 01
Field 53/74
A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
Other Provider Identifier Issuer 8: MEDI-CAL PROV TIC PIN
Field 54/74
The name of the organization, agency, or health plan that assigned the additional provider identifier. This identifies who issued the number linked to Other Provider Identifier 1 (for example, a state Medicaid agency, Medicare, or a private insurance company).
Other Provider Identifier 9: HSM30378H
Field 55/74
An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
Other Provider Identifier Type Code 9: 05
Field 56/74
A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
Other Provider Identifier State 9: CA
Field 57/74
The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
Other Provider Identifier 10: 8947230
Field 58/74
An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
Other Provider Identifier Type Code 10: 01
Field 59/74
A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
Other Provider Identifier Issuer 10: MEDI-CAL IP-X-OVER PIN
Field 60/74
The name of the organization, agency, or health plan that assigned the additional provider identifier. This identifies who issued the number linked to Other Provider Identifier 1 (for example, a state Medicaid agency, Medicare, or a private insurance company).
Other Provider Identifier 11: PHV421380
Field 61/74
An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
Other Provider Identifier Type Code 11: 05
Field 62/74
A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
Other Provider Identifier State 11: CA
Field 63/74
The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
Other Provider Identifier 12: LTC40005F
Field 64/74
An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
Other Provider Identifier Type Code 12: 05
Field 65/74
A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
Other Provider Identifier State 12: CA
Field 66/74
The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
Other Provider Identifier 13: 1807230
Field 67/74
An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
Other Provider Identifier Type Code 13: 01
Field 68/74
A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
Other Provider Identifier Issuer 13: MEDI-CAL PROV PSYCH PIN
Field 69/74
The name of the organization, agency, or health plan that assigned the additional provider identifier. This identifies who issued the number linked to Other Provider Identifier 1 (for example, a state Medicaid agency, Medicare, or a private insurance company).
Other Provider Identifier 14: HST30378H
Field 70/74
An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
Other Provider Identifier Type Code 14: 05
Field 71/74
A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
Other Provider Identifier State 14: CA
Field 72/74
The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
Is Organization Subpart: N
Field 73/74
Indicates whether the provider is a subpart of a larger organization. This is a single-character code: "Y" means the entity is an organizational subpart, while "N" means it is not. Subparts typically include hospital departments, clinics, or other distinct units that fall under a parent organization.
Authorized Official Name Prefix Text: MR.
Field 74/74
The prefix used in the name of the authorized official associated with the provider's NPI record. Examples include Mr., Ms., Mrs., Dr., or other common professional or personal prefixes.

Other Provider Identifiers 18

Legacy and payer-issued identifiers reported to the NPPES registry for this provider.

053078B000000 Medicare ID-Type Unspecified
Identifier 1/18
State: CA · Issuer: Sec 1011
Medicare ID (Type Unspecified): A Medicare-issued provider identifier whose specific subtype or program context has not been designated.
053078 Medicare ID-Type Unspecified
Identifier 2/18
State: CA · Issuer: Medicare In & Outpatient
Medicare ID (Type Unspecified): A Medicare-issued provider identifier whose specific subtype or program context has not been designated.
LTC70026G Medicaid
Identifier 3/18
State: CA
Medicaid (State-specific): A provider identification number assigned by an individual state's Medicaid program, used for billing and enrollment within that state's Medicaid system.
ZZT30378H Medicaid
Identifier 4/18
State: CA
Medicaid (State-specific): A provider identification number assigned by an individual state's Medicaid program, used for billing and enrollment within that state's Medicaid system.
8947230 Other
Identifier 5/18
Issuer: Medi-cal Ip-x-over Pin
Other: An additional provider identifier that does not correspond to any of the other defined identifier type categories.
HSM30378H Medicaid
Identifier 6/18
State: CA
Medicaid (State-specific): A provider identification number assigned by an individual state's Medicaid program, used for billing and enrollment within that state's Medicaid system.
2887230 Other
Identifier 7/18
Issuer: Medi-cal Prov Tic Pin
Other: An additional provider identifier that does not correspond to any of the other defined identifier type categories.
555217 Medicare ID-Type Unspecified
Identifier 8/18
State: CA · Issuer: Medicare Ltc
Medicare ID (Type Unspecified): A Medicare-issued provider identifier whose specific subtype or program context has not been designated.
LTC55217G Medicaid
Identifier 9/18
State: CA
Medicaid (State-specific): A provider identification number assigned by an individual state's Medicaid program, used for billing and enrollment within that state's Medicaid system.
ZZA2008Z Other
Identifier 10/18
Issuer: Blue Shield Provider
Other: An additional provider identifier that does not correspond to any of the other defined identifier type categories.
HST30378H Medicaid
Identifier 11/18
State: CA
Medicaid (State-specific): A provider identification number assigned by an individual state's Medicaid program, used for billing and enrollment within that state's Medicaid system.
9747230 Other
Identifier 12/18
Issuer: Medi-cal Prov Acute Pin
Other: An additional provider identifier that does not correspond to any of the other defined identifier type categories.
1807230 Other
Identifier 13/18
Issuer: Medi-cal Prov Psych Pin
Other: An additional provider identifier that does not correspond to any of the other defined identifier type categories.
9927230 Other
Identifier 14/18
Issuer: Medi-cal Prov Outpatient
Other: An additional provider identifier that does not correspond to any of the other defined identifier type categories.
ZZT40378H Medicaid
Identifier 15/18
State: CA
Medicaid (State-specific): A provider identification number assigned by an individual state's Medicaid program, used for billing and enrollment within that state's Medicaid system.
050378 Medicare OSCAR/certification
Identifier 16/18
State: CA
Medicare OSCAR / Certification Number: Identifies an institutional provider of services (such as a hospital, nursing home, or home health agency) assigned by CMS regional offices or state survey-certification agencies.
LTC40005F Medicaid
Identifier 17/18
State: CA
Medicaid (State-specific): A provider identification number assigned by an individual state's Medicaid program, used for billing and enrollment within that state's Medicaid system.
PHV421380 Medicaid
Identifier 18/18
State: CA
Medicaid (State-specific): A provider identification number assigned by an individual state's Medicaid program, used for billing and enrollment within that state's Medicaid system.
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