NPIMap

Organization Active NPI

California State University, Northridge

  • Community/Retail Pharmacy
  • Northridge, CA
National Provider Identifier
1942348958
Registry record updated Sep 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHE19585 Issued in CA
Legal business name
CALIFORNIA STATE UNIVERSITY, NORTHRIDGE
Practice address
18111 Nordhoff St
Northridge, CA 91330-8270
Phone
(818) 677-3666
Fax
(818) 677-7732
NPI assigned
Feb 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2014

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

Authorized official

Name
Dr. Yolanda Reid Chassiakos, M.D.NPI 1932112588
Title
Director, Student Health Center
Phone
(818) 677-3666

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PHE19585 CA Primary

Addresses

Primary practice location

18111 Nordhoff St
Northridge, CA 91330-8270

Mailing address

18111 Nordhoff St
Northridge, CA 91330-8270
Phone (818) 677-3671

Other identifiers 1

IdentifierTypeStateIssuer
PHE195850MedicaidCA

Other names 1

  • Klotz Student Health Center Pharmacy Other name

National Provider Directory

National Provider Directory
Tax ID family
Klotz Student Health Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410912000000",
    "number": "1942348958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18111 NORDHOFF ST",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913308270",
            "telephone_number": "818-677-3671",
            "fax_number": "818-677-7732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18111 NORDHOFF ST",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913308270",
            "telephone_number": "818-677-3666",
            "fax_number": "818-677-7732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA STATE UNIVERSITY, NORTHRIDGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-02",
        "last_updated": "2014-09-17",
        "status": "A",
        "authorized_official_last_name": "CHASSIAKOS",
        "authorized_official_first_name": "YOLANDA",
        "authorized_official_middle_name": "REID",
        "authorized_official_title_or_position": "DIRECTOR, STUDENT HEALTH CENTER",
        "authorized_official_telephone_number": "818-677-3666",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHE19585",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHE195850",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Klotz Student Health Center Pharmacy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Northridge, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2014; 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.