NPIMap

Organization Active NPI

San Fernando Valley Community Mental Health Center

  • Psychiatry Physician
  • Van Nuys, CA
National Provider Identifier
1164427316
Registry record updated Oct 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
D0591483 Issued in CA
Legal business name
SAN FERNANDO VALLEY COMMUNITY MENTAL HEALTH CENTER
Practice address
16360 Roscoe Blvd
2ND Floor
Van Nuys, CA 91406-1219
Phone
(818) 901-4830
Fax
(818) 785-3446
NPI assigned
Jun 15, 2005
Last updated
Oct 18, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Timothy Ryder
Title
President
Phone
(818) 901-4830

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X D0591483 CA Primary

Addresses

Primary practice location

16360 Roscoe Blvd
2ND Floor
Van Nuys, CA 91406-1219

Mailing address

16360 Roscoe Blvd
2ND Floor
Van Nuys, CA 91406-1219
Phone (818) 901-4830

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040528001000 CA Part B Supplier - Clinic/Group Practice 1456332998 Receives reassigned benefits from 11 practitioners
Practice locations: North Hollywood, CA; Van Nuys, CA

National Provider Directory

National Provider Directory
Tax ID family
San Fernando Valley Community Mental Health Center Inc44 organizations share this tax ID, including this one

Other organizations with this tax ID 43

Organizations that report the same tax identification number in the National Provider Directory.

View all 43

Locations

14545 Hamlin St
Ste 200
Van Nuys, CA 91411

14600 Sherman Way
Ste 100D
Van Nuys, CA 91405
Phone (818) 901-4854

16360 Roscoe Blvd
Fl 2
Van Nuys, CA 91406
Phone (818) 908-4999

16650 Sherman Way
Van Nuys, CA 91406
Phone (818) 785-0103

Practitioners & affiliated clinicians

Practitioners 48

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 48

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1118793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697587200000",
    "number": "1164427316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16360 ROSCOE BLVD",
            "address_2": "2ND FLOOR",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914061219",
            "telephone_number": "818-901-4830",
            "fax_number": "818-785-3446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16360 ROSCOE BLVD",
            "address_2": "2ND FLOOR",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914061219",
            "telephone_number": "818-901-4830",
            "fax_number": "818-785-3446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN FERNANDO VALLEY COMMUNITY MENTAL HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-15",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A",
        "authorized_official_last_name": "RYDER",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-901-4830"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "D0591483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.