MEDICARE: NORTHEAST VALLEY HEALTH CORPORATION

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	261QC1500X	Community Health Clinic/Center
2	261QF0400X	Federally Qualified Health Center (FQHC)

General Provider Information

NPI Number	:	1487517850
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHEAST VALLEY HEALTH CORPORATION

Provider Business Mailing Address
First Line	:	1172 N MACLAY AVE
Second Line	:
City	:	SAN FERNANDO
State	:	CA
Zip	:	91340-1328
Country	:	US
Telephone Number	:	818-898-1388
Fax Number	:

Provider Business Practice Location Address
First Line	:	6416 TAMPA AVE.
Second Line	:
City	:	RESEDA
State	:	CA
Zip	:	91335-6647
Country	:	US
Telephone Number	:	818-946-3444
Fax Number	:

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	CHRISTOPHER REED
Credential	:
Telephone Number	:	818-898-1388

Provider Enumeration Date	:	12/03/2025
Last Update Date	:	12/03/2025

Similar Medicare Providers

1306120043 — DR. KRITTAPORN NAN ROSENTHAL PHARM.D.
Practice Location Address:

6416 TAMPA AVE
RESEDA, CA
91335-6647

Practice Phone: 818-776-9014
Practice Fax: 818-776-5654

1538304084 — WALGREEN CO.
Practice Location Address:

6416 TAMPA AVE
TARZANA, CA
91335-6647

Practice Phone: 818-776-9014
Practice Fax:

1760764401 — APRIL NATESIRI
Practice Location Address:

6416 TAMPA AVE
TARZANA, CA
91335-6647

Practice Phone: 818-776-9014
Practice Fax:

1982975553 — YARA TUMEH
Practice Location Address:

6416 TAMPA AVE
TARZANA, CA
91335-6647

Practice Phone: 818-776-9014
Practice Fax:

1295269496 — LINDA BANAFSHEHA PHARMD
Practice Location Address:

6416 TAMPA AVE
TARZANA, CA
91335-6647

Practice Phone: 818-776-9014
Practice Fax:

1386579753 — JOSEPH DANIEL LEE
Practice Location Address:

18600 LANARK ST
RESEDA, CA
91335-1233

Practice Phone: 818-882-2496
Practice Fax:

Directions to “NORTHEAST VALLEY HEALTH CORPORATION ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.