NPIMap

Organization Active NPI

San Fernando Valley Community Mental Health Center, Inc.

  • Psychiatry Physician
  • Lake Balboa, CA
National Provider Identifier
1992209639
Registry record updated Mar 9, 2020
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
Youth Contact Mulholland MS
Practice address
17120 Vanowen St
Lake Balboa, CA 91406-4449
Phone
(818) 609-2500
NPI assigned
Mar 19, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2020

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

17120 Vanowen St
Lake Balboa, CA 91406-4449

Mailing address

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

Other names 1

  • Youth Contact Mulholland MS 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

17120 Vanowen St
Lake Balboa, CA 91406
Phone (818) 609-2500

NPI Registry JSON

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

{
    "created_epoch": "1521417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583712000000",
    "number": "1992209639",
    "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": "818-901-4830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17120 VANOWEN ST",
            "city": "LAKE BALBOA",
            "state": "CA",
            "postal_code": "914064449",
            "telephone_number": "818-609-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN FERNANDO VALLEY COMMUNITY MENTAL HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-19",
        "last_updated": "2020-03-09",
        "certification_date": "2020-03-09",
        "status": "A",
        "authorized_official_last_name": "RYDER",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "PRESIDEN",
        "authorized_official_telephone_number": "818-901-4830"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Youth Contact Mulholland MS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Youth Contact Mulholland MS",
            "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 Mar 9, 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.