Individual provider Active NPI

Honorine Penoria Pengho, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1750625588
Registry record updated May 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
688401 Issued in CA
Practice address
4945 Angeles Vista Blvd
Los Angeles, CA 90043-1724
Phone
(310) 409-5160
NPI assigned
Nov 16, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Clinical Nurse Specialist 364SA2100X 21236 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 688401 CA Primary

Addresses

Primary practice location

4945 Angeles Vista Blvd
Los Angeles, CA 90043-1724

Mailing address

4945 Angeles Vista Blvd
Los Angeles, CA 90043-1724
Phone (310) 409-5160

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230315002490 CA Practitioner - Nurse Practitioner 5991179889 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Meticulous Health Care PCGroup PAC ID 1759757305, 6 clinicians

Practice addresses (Care Compare)

6850 Sepulveda Blvd
Suite 217
Van Nuys, CA 91405-4466
Phone (818) 901-7855

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
688401CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mendrix Medical Associates Inc Psychiatric/Mental Health CurrentSince Feb 24, 2025 Accepting new patients
Meticulous Health Care PC CurrentSince Jan 1, 2023 Accepting new patients

Locations

18726 S Western Ave
Ste 320
Gardena, CA 90248
Phone (213) 373-3301

245 Cherry Ave
Long Beach, CA 90802
Phone (562) 435-9363

8601 Lincoln Blvd
Ste 108567
Los Angeles, CA 90045

1623 Arizona Ave
Santa Monica, CA 90404
Phone (213) 373-3301

6850 Sepulveda Blvd
Ste 217
Van Nuys, CA 91405
Phone (818) 901-7855

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1353024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746748800000",
    "number": "1750625588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4945 ANGELES VISTA BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900431724",
            "telephone_number": "310-409-5160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4945 ANGELES VISTA BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900431724",
            "telephone_number": "310-409-5160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENGHO",
        "first_name": "HONORINE",
        "middle_name": "PENORIA",
        "name_prefix": "Miss",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-16",
        "last_updated": "2025-05-09",
        "certification_date": "2025-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2100X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Acute Care",
            "state": "CA",
            "license": "21236",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "688401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.