NPI
Jennie D Phouthavong
NPI 1285429654
Read from the NPPES registry on October 23, 2026.
Facts
- Status
- Active
- Type
- Individual
- Enumeration date
- 2025-04-14
- Last updated
- 2025-04-14
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Specialties
Licenses
- License CA
- PTA48583
Location
- Practice location
- 300 Lantern Crest Way
- City
- Santee CA
- Postal code
- 92071-4775
- Phone
- (619) 312-0929
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
No exclusion found for this NPI in the OIG LEIE file dated October 9, 2026. Confirm on OIG's online search.
Nearby
Other NPIs in Santee, CA. 859 records in the public file.
Public data from NPPES and CMS. Not a credentialing determination.
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