| Sfvcmhc Youth Contact Fccs | |
|
6400 Laurel Canyon Blvd Ste 500 North Hollywood CA 91606-1562 | |
| (818) 908-4990 | |
| (818) 997-3138 |
| Full Name | Sfvcmhc Youth Contact Fccs |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 6400 Laurel Canyon Blvd Ste 500, North Hollywood, California |
| Authorized Official Name and Position | Timothy Ryder (PRESIDENT) |
| Authorized Official Contact | 8189014830 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sfvcmhc Youth Contact Fccs 16360 Roscoe Blvd Suite 200 Van Nuys CA 91406-1219 Ph: (818) 901-4830 | Sfvcmhc Youth Contact Fccs 6400 Laurel Canyon Blvd Ste 500 North Hollywood CA 91606-1562 Ph: (818) 908-4990 |
| NPI Number | 1023148970 |
|---|---|
| Provider Enumeration Date | 03/07/2007 |
| Last Update Date | 11/10/2023 |
| Certification Date | 11/10/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023148970 | NPI | - | NPPES |
| 000007355 | Other | CA | MEDICAL PROVIDER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | D0591483 (California) | Primary |
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