MEDICARE: SANTA CLARITA VALLEY MENTAL HEALTH CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	LCS21039	CA

General Provider Information

NPI Number	:	1336221670
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SANTA CLARITA VALLEY MENTAL HEALTH CENTER

Provider Business Mailing Address
First Line	:	25050 PEACHLAND AVE
Second Line	:	203
City	:	NEWHALL
State	:	CA
Zip	:	91321-2523
Country	:	US
Telephone Number	:	661-222-2800
Fax Number	:	661-255-3428

Provider Business Practice Location Address
First Line	:	25050 PEACHLAND AVE
Second Line	:	203
City	:	NEWHALL
State	:	CA
Zip	:	91321-2523
Country	:	US
Telephone Number	:	661-222-2800
Fax Number	:	661-255-3428

Authorized Official
Title or Position	:	PSYCHIATRIC SOCIAL WORKER
Name	:	MS. SUSAN H SPEER
Credential	:	L.C.S.W.
Telephone Number	:	661-222-2800

Provider Enumeration Date	:	10/19/2006
Last Update Date	:	08/22/2020

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