Individual provider Active NPI

Phanny Hoeum, RN

  • Registered Nurse
  • Culver City, CA
National Provider Identifier
1740703974
Registry record updated Mar 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
95408671 Issued in CA
Practice address
9808 Venice Blvd Ste 500
Culver City, CA 90232-2732
Phone
(310) 945-3356
NPI assigned
Jul 19, 2017
Last updated
Mar 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 95408671 CA Primary
Licensed Vocational Nurse 164X00000X 690114 CA

Addresses

Primary practice location

9808 Venice Blvd Ste 500
Culver City, CA 90232-2732

Mailing address

9808 Venice Blvd Ste 500
Culver City, CA 90232-2732
Phone (310) 945-3356

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
95408671CAMDRegistered Nurse
690114CAMDLicensed Vocational Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Orange County Association for Mental Health PastSince Oct 1, 2021 Accepting new patients
Orange County Association for Mental Health PastSince Oct 1, 2021 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1500422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741478400000",
    "number": "1740703974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9808 VENICE BLVD STE 500",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902322732",
            "telephone_number": "310-945-3356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9808 VENICE BLVD STE 500",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902322732",
            "telephone_number": "310-945-3356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOEUM",
        "first_name": "PHANNY",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-19",
        "last_updated": "2025-03-09",
        "certification_date": "2025-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95408671",
            "primary": true
        },
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "690114",
            "primary": false
        }
    ],
    "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 Mar 9, 2025; 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.