NPIMap

Organization Active NPI

San Fernando Valley Community Mental Health Center, Inc.

Doing business as Independence Continuation High School

  • Psychiatry Physician
  • Lake Balboa, CA
National Provider Identifier
1295608800
Registry record updated Sep 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
SAN FERNANDO VALLEY COMMUNITY MENTAL HEALTH CENTER, INC.
Doing business as
Independence Continuation High School
Practice address
6501 Balboa Blvd
Lake Balboa, CA 91406-5526
Phone
(818) 901-4930
Fax
(818) 785-4118
NPI assigned
Sep 29, 2025
Last updated
Sep 29, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2025

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X NU Primary

Addresses

Primary practice location

6501 Balboa Blvd
Lake Balboa, CA 91406-5526

Mailing address

16360 Roscoe Blvd FL 2
Van Nuys, CA 91406-1219
Phone (818) 901-4930

Other identifiers 1

IdentifierTypeStateIssuer
000007320MedicaidCA

Other names 1

  • INDEPENDENCE CONTINUATION HIGH SCHOOL Doing business as

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

6501 Balboa Blvd
Lake Balboa, CA 91406
Phone (818) 901-4930

NPI Registry JSON

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

{
    "created_epoch": "1759104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759104000000",
    "number": "1295608800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16360 ROSCOE BLVD FL 2",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914061219",
            "telephone_number": "818-901-4930",
            "fax_number": "818-785-4118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6501 BALBOA BLVD",
            "city": "LAKE BALBOA",
            "state": "CA",
            "postal_code": "914065526",
            "telephone_number": "818-901-4930",
            "fax_number": "818-785-4118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN FERNANDO VALLEY COMMUNITY MENTAL HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-29",
        "last_updated": "2025-09-29",
        "certification_date": "2025-09-29",
        "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",
        "authorized_official_credential": "PRESIDENT"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000007320",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "INDEPENDENCE CONTINUATION HIGH SCHOOL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake Balboa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.