OrganizationActive
Independence Community Treatment Clinic
NPI 1508039728 · Community Health Clinic/Center · Lancaster, CA
Provider details
- NPI number
- 1508039728
- 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(87/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 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
209 W Avenue J
Rooms E,g, H, Front Office
Lancaster, CA 93534-3656
Phone: (818) 776-1755
Fax: (818) 776-1657
Street-level locationGet directions
Mailing address
19231 Victory Blvd
Reseda, CA 91335-6308
Registry dates
- Enumerated
- 2008-04-09
- Last updated
- 2010-07-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.