Provider Demographics
NPI:1346744075
Name:SAN FERNANDO VALLEY COMMUNITY MENTAL HEALTH CENTER, INC.
Entity Type:Organization
Organization Name:SAN FERNANDO VALLEY COMMUNITY MENTAL HEALTH CENTER, INC.
Other - Org Name:YOUTH CONTACT COHASSET ES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR QUALITY MANAGEMENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:SINAI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-901-4830
Mailing Address - Street 1:16360 ROSCOE BLVD FL 2
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91406-1219
Mailing Address - Country:US
Mailing Address - Phone:818-901-4830
Mailing Address - Fax:
Practice Address - Street 1:15810 SATICOY ST
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91406-3128
Practice Address - Country:US
Practice Address - Phone:818-787-2113
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-19
Last Update Date:2018-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Multi-Specialty