Michelle L Penfold

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

235 W 9TH St
San Pedro, CA 90731-3711

Phone

(949) 891-3904

Fax

(310) 831-5796

NPI assigned

Jan 11, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1515628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515628800000",
    "number": "1255849287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 W 9TH ST",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907313712",
            "telephone_number": "949-891-3904",
            "fax_number": "310-831-5796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 W 9TH ST",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907313711",
            "telephone_number": "949-891-3904",
            "fax_number": "310-831-5796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENFOLD",
        "first_name": "MICHELLE",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-11",
        "last_updated": "2018-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ethan Michael Pearson, AMFT
• Mavis Elizabeth Pearson
• Juliette Peat
• Melissa Frances Pedersen, MFT
• Brandon Louis Pena
• Hsiao P Peng, D.D.S.
• Peninsula Anesthesia Group, Inc.
• Peninsula Eyecare Medical Associates
• Peninsula Outpatient Surgery Center, Inc.
• Peninsula Pharmacy

• Addiction (Substance Use Disorder) Counselor in San Pedro, CA
• Providers in San Pedro, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.