Provider Demographics
NPI:1306139886
Name:NEWHALL HEALTH CENTER
Entity type:Organization
Organization Name:NEWHALL HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:LAYMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-257-7892
Mailing Address - Street 1:25115 AVENUE STANFORD
Mailing Address - Street 2:A-104
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-1290
Mailing Address - Country:US
Mailing Address - Phone:661-257-7892
Mailing Address - Fax:
Practice Address - Street 1:23772 NEWHALL AVE
Practice Address - Street 2:
Practice Address - City:NEWHALL
Practice Address - State:CA
Practice Address - Zip Code:91321-3125
Practice Address - Country:US
Practice Address - Phone:661-291-1777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SAMUEL DIXON FAMILY HEALTH CENTERS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-05-17
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550001113251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA550001113OtherLICENSE