| San Fernando Valley Community Mental Health Center | |
|
16360 Roscoe Blvd 2nd Floor Van Nuys CA 91406-1219 | |
| (818) 901-4830 | |
| (818) 785-3446 |
| Full Name | San Fernando Valley Community Mental Health Center |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 16360 Roscoe Blvd, Van Nuys, California |
| Authorized Official Name and Position | Timothy Ryder (PRESIDENT) |
| Authorized Official Contact | 8189014830 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| San Fernando Valley Community Mental Health Center 16360 Roscoe Blvd 2nd Floor Van Nuys CA 91406-1219 Ph: (818) 901-4830 | San Fernando Valley Community Mental Health Center 16360 Roscoe Blvd 2nd Floor Van Nuys CA 91406-1219 Ph: (818) 901-4830 |
| NPI Number | 1164427316 |
|---|---|
| Provider Enumeration Date | 06/15/2005 |
| Last Update Date | 10/18/2023 |
| Certification Date | 10/18/2023 |
| Medicare PECOS PAC ID | 1456332998 |
|---|---|
| Medicare Enrollment ID | O20040528001000 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164427316 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | D0591483 (California) | Primary |
| Provider Name | Julio A Montano |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1356360226 PECOS PAC ID: 3375647746 Enrollment ID: I20070326000258 |
| Provider Name | Howard Lee Myerhoff |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1831230069 PECOS PAC ID: 7012014889 Enrollment ID: I20070514000399 |
| Provider Name | Colin P Dias |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811029168 PECOS PAC ID: 2466536990 Enrollment ID: I20080222000248 |
| Provider Name | Lucy Pei-ju P Liao |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194973990 PECOS PAC ID: 9638223167 Enrollment ID: I20090819000196 |
| Provider Name | Erik S Paschall |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265621791 PECOS PAC ID: 9739375726 Enrollment ID: I20101202000818 |
| Provider Name | William C Darby |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023455359 PECOS PAC ID: 9234448853 Enrollment ID: I20151022000869 |
| Provider Name | Erica Metu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861938623 PECOS PAC ID: 1052687902 Enrollment ID: I20171020003116 |
| Provider Name | Taiye Owareye Osawe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396116703 PECOS PAC ID: 1254679921 Enrollment ID: I20190205003531 |
| Provider Name | Seung Kyum Lee |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871025098 PECOS PAC ID: 5496096752 Enrollment ID: I20190521000743 |
| Provider Name | Kevin S Zhang |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225370885 PECOS PAC ID: 6103258751 Enrollment ID: I20191119003333 |
| Provider Name | Jobert B Poblete |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063944759 PECOS PAC ID: 4880925288 Enrollment ID: I20191121001917 |
| Provider Name | Laura Obler |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013448711 PECOS PAC ID: 9830420231 Enrollment ID: I20191121003205 |
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