Michael Penilla, LVN

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

VN685275 Issued in CA

Practice address

8898 Clairemont Mesa Blvd
San Diego, CA 92123-1147

Phone

(619) 966-3389

NPI assigned

Nov 28, 2023

Sex

Male

Sole proprietor

Yes

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

State licenses

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

{
    "created_epoch": "1701129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1295501526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3136 MASSACHUSETTS AVE",
            "city": "LEMON GROVE",
            "state": "CA",
            "postal_code": "919452227",
            "telephone_number": "619-786-4206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8898 CLAIREMONT MESA BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231147",
            "telephone_number": "619-966-3389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENILLA",
        "first_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "LVN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-11-28",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "VN685275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Peng
• Raymond Peng, PSYD
• Wenjing Peng
• Michelle Peniche
• Patricia Louise Penick, PT
• Peninsula Hearing Center, Inc
• Vivianna Penn
• Zaniecia Penn
• Michael Andre Penna
• Laura Pennelle, LCSW, JD

• Licensed Vocational Nurse in San Diego, CA
• Providers in San Diego, CA by specialty
• Licensed Vocational Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2023; 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.