Individual provider Active NPI

Yvette Penick

  • Marriage & Family Therapist
  • Culver City, CA
National Provider Identifier
1629330477
Registry record updated Jun 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
70359 Issued in CA
Practice address
5701 W Slauson Ave Ste 140
Culver City, CA 90230-6503
Phone
(310) 770-6792
NPI assigned
Jun 7, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 70359 CA Primary

Addresses

Primary practice location

5701 W Slauson Ave Ste 140
Culver City, CA 90230-6503

Mailing address

PO Box 35192
Los Angeles, CA 90035-0192
Phone (310) 770-6792

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1339027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339372800000",
    "number": "1629330477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35192",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900350192",
            "telephone_number": "310-770-6792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 W SLAUSON AVE STE 140",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902306503",
            "telephone_number": "310-770-6792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENICK",
        "first_name": "YVETTE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-07",
        "last_updated": "2012-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "70359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Culver City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2012; 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.