Healthcare Provider Details

I. General information

NPI: 1588740989
Provider Name (Legal Business Name): VALLEY COMMUNITY HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 06/20/2024
Certification Date: 06/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6801 COLDWATER CANYON AVE
NORTH HOLLYWOOD CA
91605-5162
US

IV. Provider business mailing address

6801 COLDWATER CANYON AVE
NORTH HOLLYWOOD CA
91605-5162
US

V. Phone/Fax

Practice location:
  • Phone: 818-763-1718
  • Fax: 818-763-7231
Mailing address:
  • Phone: 818-763-1718
  • Fax: 818-763-7231

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number960000122
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name: ANITA ZAMORA
Title or Position: PRESIDENT/CEO
Credential:
Phone: 818-763-1718