Provider Demographics
NPI:1801663695
Name:SFV HEALTH CENTER, INC.
Entity type:Organization
Organization Name:SFV HEALTH CENTER, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:KISHIYAMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-935-4452
Mailing Address - Street 1:8426 SUNLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:SUN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91352-3436
Mailing Address - Country:US
Mailing Address - Phone:818-935-4452
Mailing Address - Fax:818-356-8739
Practice Address - Street 1:9375 SAN FERNANDO RD STE 2A
Practice Address - Street 2:
Practice Address - City:SUN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91352-1428
Practice Address - Country:US
Practice Address - Phone:818-504-4514
Practice Address - Fax:747-245-1096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA116651Medicaid