Provider Demographics
NPI:1487830725
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:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR: CASC
Authorized Official - Prefix:DR
Authorized Official - First Name:SERINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSENKJAR
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:818-285-1900
Mailing Address - Street 1:5935 VAN NUYS BLVD
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91401-3624
Mailing Address - Country:US
Mailing Address - Phone:818-285-1900
Mailing Address - Fax:818-285-1906
Practice Address - Street 1:6931 VAN NUYS BLVD
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-3937
Practice Address - Country:US
Practice Address - Phone:818-901-4830
Practice Address - Fax:818-785-3446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-17
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY18963251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health