Pennacle Foundation, Inc.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

PENNACLE FOUNDATION, INC.

Practice address

5125 Crenshaw Blvd
Los Angeles, CA 90043-1853

Phone

(323) 750-2400

Fax

(323) 825-5660

NPI assigned

Aug 18, 2014

Organization subpart

No

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

Authorized official

Name

Carolyn Ruffin

Title

Executive Director

Phone

(323) 750-2400

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1408320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408320000000",
    "number": "1942609771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 18224",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900180224",
            "telephone_number": "323-750-2400",
            "fax_number": "323-825-5660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5125 CRENSHAW BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900431853",
            "telephone_number": "323-750-2400",
            "fax_number": "323-825-5660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENNACLE FOUNDATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-18",
        "last_updated": "2014-08-18",
        "status": "A",
        "authorized_official_last_name": "RUFFIN",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "323-750-2400"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Penn
• Casey Penn
• Elton John Penn
• Marquisha Daitierra Penn
• Renee Johannah Penn, MD
• John Pennella
• Kristine Renee Penner Klein, MD
• Amy Beth Penner, LCSW
• Kelli Penner, M.S., LMFT 79102
• Keith Pennetti, PT

• Community/Behavioral Health Agency in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Community/Behavioral Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2014; 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.