Vida Community Clinic

Primary specialty

Community Health Clinic/CenterTaxonomy code 261QC1500X

Legal business name

VIDA COMMUNITY CLINIC

Practice address

1519 Woodworth St
San Fernando, CA 91340-4153

Phone

(818) 332-0463

NPI assigned

Sep 18, 2020

Organization subpart

No

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

Authorized official

Name

Ana Ruiz, PA

Title

Ed

Phone

(818) 425-9437

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1600387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600387200000",
    "number": "1891301578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10718 WHITE OAK AVE UNIT 6",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913444628",
            "telephone_number": "818-425-9437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1519 WOODWORTH ST",
            "city": "SAN FERNANDO",
            "state": "CA",
            "postal_code": "913404153",
            "telephone_number": "818-332-0463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIDA COMMUNITY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-18",
        "last_updated": "2020-09-18",
        "certification_date": "2020-09-18",
        "status": "A",
        "authorized_official_last_name": "RUIZ",
        "authorized_official_first_name": "ANA",
        "authorized_official_title_or_position": "ED",
        "authorized_official_telephone_number": "818-425-9437",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community Health Clinic/Center in San Fernando, CA
• Providers in San Fernando, CA by specialty
• Community Health Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2020; 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.