Amy Beth Penner, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW96724 Issued in CA

Practice address

6500 Wilshire Blvd FL 19
Los Angeles, CA 90048-4920

Phone

(805) 764-9651

Fax

(747) 330-1670

NPI assigned

Jul 23, 2015

Last updated

Mar 30, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pacific Heritage Medical Group IncGroup PAC ID 7517284029, 62 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pacific Heritage Medical Group Inc

  • Geriatric Psychiatry Physician
  • Westlake Village, CA
  • NPI 1467899450
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1437609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774828800000",
    "number": "1144605742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1223 WILSHIRE BLVD UNIT 3189",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904035406",
            "telephone_number": "805-764-9651",
            "fax_number": "747-330-1670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 WILSHIRE BLVD FL 19",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900484920",
            "telephone_number": "805-764-9651",
            "fax_number": "747-330-1670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNER",
        "first_name": "AMY",
        "middle_name": "BETH",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-23",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW96724",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marquisha Daitierra Penn
• Renee Johannah Penn, MD
• Pennacle Foundation, Inc.
• John Pennella
• Kristine Renee Penner Klein, MD
• Kelli Penner, M.S., LMFT 79102
• Keith Pennetti, PT
• Natahviya T Penniman
• Mackenzie L. Pennington, PA-C
• Marissa Pennino

• Clinical Social Worker in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.