PACOIMA HEALTH CENTER
NPI 1114928595
Clinic/Center - Federally Qualified Health Center (FQHC) in Pacoima, CA
NPI Status: Active since August 09, 2005
Contact Information
12756 VAN NUYS BLVD
PACOIMA, CA
ZIP 91331
Phone: (818) 896-0531
Fax: (818) 896-5850
- Organization
- Clinic/Center
- Federally Qualified Health Center (FQHC)
- CLIA Number: 05D0666584
- CLIA Cert. Type: Community Clinic
- CLIA Exp. Date: 08-31-2026
About PACOIMA HEALTH CENTER
This page provides the complete NPI Profile along with additional information for Pacoima Health Center, a primary care provider established in Pacoima, California operating as a Clinic/center, focusing in federally qualified health center (fqhc) . The healthcare provider is registered in the NPI registry with number 1114928595 assigned on August 2005. The practitioner's primary taxonomy code is 261QF0400X. The provider is registered as an organization and their NPI record was last updated 4 years ago. Pacoima Health Center operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The provider's is doing business as Pacoima Health Center. The authorized official of this NPI record is Mrs. Kimberly Wyard (Chief Executive Officer)
- NPI
- 1114928595
- Provider Legal Name
- NORTHEAST VALLEY HEALTH CORPORATION
- Other Organization Name
- PACOIMA HEALTH CENTER
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 12756 VAN NUYS BLVD PACOIMA, CA 91331
- Location Phone
- (818) 896-0531
- Location Fax
- (818) 896-5850
- Mailing Address
- 1172 N MACLAY AVE SAN FERNANDO, CA 91340
- Mailing Phone
- (818) 898-1388
- Mailing Fax
- (818) 896-5850
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 08-09-2005
- Last Update Date
- 02-22-2022
- Code Navigator
A primary care provider (PCP) like Pacoima Health Center sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Federally Qualified Health Center (FQHC)
- Taxonomy Code
- 261QF0400X
- Type
- Ambulatory Health Care Facilities
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 171M00000X | Other Service Providers | Case Manager/Care Coordinator | |
| 2 | 261QC1500X | Ambulatory Health Care Facilities | Clinic/Center | 9600189 (CA) |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| W14819A | OTHER (01) | MIN |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 05D0666584
- Facility Type
- Community Clinic
- Certificate Effective Date
- September 01, 2024
- Certificate Expiration Date
- August 31, 2026
- Laboratory Director
- GINA JOHNSON
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to Pacoima Health Center in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
Reviews for PACOIMA HEALTH CENTER
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 1 | 1 | 4 | 9 | 2 | 8 | 5 | 9 | 5 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 1 | 2 | 4 | 18 | 2 | 16 | 5 | 18 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 1 + 2 + 4 + 1 + 8 + 2 + 1 + 6 + 5 + 1 + 8 + 24 = 65 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 65 = 5 | 5 | ||||||||
The NPI number 1114928595 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 19 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1124029947 | MS. LATONYA BURNELL N.P. Individual | Nurse Practitioner (Obstetrics & Gynecology) | 12756 VAN NUYS BLVD PACOIMA, CA 91331 (818) 896-0531 |
| 1538160320 | FE A NAVARREZ NP Individual | Nurse Practitioner (Obstetrics & Gynecology) | 12756 VAN NUYS BLVD PACOIMA, CA 91331 (818) 896-0531 |
| 1891796686 | MS. DEBORAH A ROSKAMP FNP Individual | Nurse Practitioner (Pediatrics) | 12756 VAN NUYS BLVD PACOIMA, CA 91331 (818) 896-0531 |
| 1902807605 | MRS. DARLENE MARIE WALTERS MSN, RNP-C Individual | Nurse Practitioner (Obstetrics & Gynecology) | 12756 VAN NUYS BLVD PACOIMA, CA 91331 (818) 896-0531 |
| 1568463172 | DAVID LAWRENCE MCINTOSH M.D. Individual | Internal Medicine | 12756 VAN NUYS BLVD PACOIMA, CA 91331 (818) 896-0531 |
| 1497756555 | JESSE DAVID SANDERS JR. M.D. Individual | Family Medicine | 12756 VAN NUYS BLVD PACOIMA, CA 91331 (818) 896-0531 |
| 1386637031 | MRS. URMILA (UMI) MUKHERJEE RNP/CNM Individual | Nurse Practitioner (Obstetrics & Gynecology) | 12756 VAN NUYS BLVD PACOIMA, CA 91331 (818) 896-0531 |
| 1679568521 | WENDY JANET FIELDS M.D. Individual | Pediatrics | 12756 VAN NUYS BLVD PACOIMA, CA 91331 (818) 896-0531 |
| 1396872537 | MRS. DIANA PEREZ NUNEZ NURSE PRACTITIONER Individual | Nurse Practitioner (Obstetrics & Gynecology) | 12756 VAN NUYS BLVD PACOIMA, CA 91331 (818) 896-0531 |
| 1972768844 | MISS MARIAH PIGNONE P.A. Individual | Physician Assistant (Medical) | 12756 VAN NUYS BLVD PACOIMA, CA 91331 (818) 896-0531 |
| 1366696395 | NAVEEN KUMAR DHIMAN M.D. Individual | Family Medicine | 12756 VAN NUYS BLVD PACOIMA, CA 91331 (818) 896-0531 |
| 1891017349 | MRS. LLONA AVELIN MEARIG N.P. Individual | Nurse Practitioner | 12756 VAN NUYS BLVD PACOIMA, CA 91331 (818) 896-0531 |
| 1013220938 | JENNY L. YOON NP Individual | Nurse Practitioner (Pediatrics) | 12756 VAN NUYS BLVD PACOIMA, CA 91331 (818) 896-0531 |
| 1093111718 | MS. CAROLINA HERRERA RDN Individual | Dietitian, Registered | 12756 VAN NUYS BLVD PACOIMA, CA 91331 (818) 896-0531 |
| 1821297110 | DR. YOLANDA MARIA CESPEDES-KNADLE PH.D. Individual | Psychologist (Clinical) | 12756 VAN NUYS BLVD PACOIMA, CA 91331 (818) 896-0531 |
| 1760483564 | ANA D SARAVIA M.D., MPH Individual | Pediatrics | 12756 VAN NUYS BLVD PACOIMA, CA 91331 (818) 896-0531 |
| 1568794550 | JACQUELINE GARCIA Individual | Social Worker (Clinical) | 12756 VAN NUYS BLVD PACOIMA, CA 91331 (818) 896-0531 |
| 1477843365 | CRISTINA L. VIGIL SOCIAL WORKER Individual | Social Worker | 12756 VAN NUYS BLVD PACOIMA, CA 91331 (818) 896-0531 |
| 1568949543 | DR. DANIELLE LALIMAR CORTEZ PHARMD Individual | Pharmacist (Ambulatory Care) | 12756 VAN NUYS BLVD PACOIMA, CA 91331 (818) 896-0531 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1114928595, enumerated in the NPI registry as an "organization" on August 09, 2005
The provider is located at 12756 Van Nuys Blvd Pacoima, Ca 91331 and the phone number is (818) 896-0531
This medical organization specializes in Clinic/Center with taxonomy code 261QF0400X with a focus in Federally Qualified Health Center (FQHC)
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 05D0666584 for a "community clinic" facility with a CLIA Certificate for Provider-Performed Microscopy Procedures (PPMP). This CLIA certificate is issued in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing..
This NPI record was last updated on August 09, 2005. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.