OrganizationActive
Independence Community Treatment Clinic
NPI 1417192550 · Community Health Clinic/Center · Quartz Hill, CA
Provider details
- NPI number
- 1417192550
- Entity type
- Organization
- Primary specialty
- Community Health Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Alex Branzburg, Program Director(818) 776-1755
- License
- 960001358 (CA)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(86/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
6040 W Avenue L
Room423,v3, Agi
Quartz Hill, CA 93536-4501
Phone: (818) 776-1755
Fax: (818) 776-1657
Street-level locationGet directions
Mailing address
19231 Victory Blvd
Reseda, CA 91335-6308
Registry dates
- Enumerated
- 2008-12-03
- Last updated
- 2009-12-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.