Penny Jo Broadway

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

1529 E Palmdale Blvd
Suite 210
Palmdale, CA 93550-2034

Phone

(661) 272-9996

NPI assigned

Jun 7, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• All for Kids Organization

  • Community/Behavioral Health Agency
  • Palmdale, CA
  • NPI 1609902436
  NPD (past)

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198972800000",
    "number": "1922201797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45351 11TH ST W",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935341706",
            "telephone_number": "661-726-1978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1529 E PALMDALE BLVD",
            "address_2": "SUITE 210",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935502034",
            "telephone_number": "661-272-9996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROADWAY",
        "first_name": "PENNY",
        "middle_name": "JO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-07",
        "last_updated": "2007-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00007301A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brisben Med, Inc.
• Maribel Briseno
• Cassandra Edisa Brito, BA
• Melissa Marie Brittain, RDMS
• Taylor Annette Britton
• Isaiah Bronson
• Aaliyah Shantel Brooks
• Chandra Evettemarie Brooks
• Ebony M Brooks
• Stevi Brott

• Clinical Social Worker in Palmdale, CA
• Providers in Palmdale, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2007; 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.