TOMMY PHOUKHAOTHONG PANYANOUVONG (NPI# 1407126469) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407126469 |
| Entity Type | Individual |
| Full Name | TOMMY PHOUKHAOTHONG PANYANOUVONG |
| Practice Address |
1300 Payne Ave Modesto CA 95351-4821 |
| Mailing Address |
800 Scenic Dr Modesto CA 95350-6131 |
| Practice Telephone | 2095410662 |
| Mailing Telephone | 2095584464 |
| Enumeration Date | 2012-01-09 |
| Last Update Date | 2012-01-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Street Address |
1300 PAYNE AVE |
| City | MODESTO |
| State | CA |
| Zip Code | 95351-4821 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700392487 | Western Dental Services, Inc. | Dentist | 1524 Richland Ave, Ceres, CA 95351 | 2017-12-18 |
| 1881039873 | Sabrina Arora-thissen | Family Medicine | 401 Paradise Rd. Ste, Modesto, CA 95351 | 2013-05-03 |
| 1407163561 | Maliza Cahee Oliver | Dentist | 1404 Mitchell Rd, Modesto, CA 95351 | 2010-09-09 |
| 1124345616 | Jason Lee Paul Wayrynen | Social Worker | 1219 N Carpenter Rd Ste 12, Modesto, CA 95351 | 2010-04-23 |
| 1841469640 | Edgar Hse-hwa Han | Physical Medicine & Rehabilitation | 1521 N. Carpenter Road, Suite D-1, Modesto, CA 95351 | 2008-02-26 |
| 1326259326 | Karen Ann Peterson | Nurse Practitioner | 1340 Mitchell Rd, Modesto, CA 95351 | 2007-05-24 |
| 1013139054 | Bounchanh Trysavath | Physician Assistant | 300 I St, Modesto, CA 95351 | 2007-05-02 |
| 1245363464 | Sharon Basaldua1 | Counselor | 813 Moon Lane, Modesto, CA 95351 | 2007-03-14 |
| 1710046834 | Phil Chen | Dentist | 1460 Mitchell Road, Suite B, Modesto, CA 95351 | 2006-12-06 |
| 1649366055 | Victor Y. Chen | Family Medicine | 401 Paradise Road, Suite E, Modesto, CA 95351 | 2006-10-04 |
| Find all providers in zip 95351 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043845357 | Anthony Rodriguez Contreras | Counselor | 2360 Scenic Dr, Modesto, CA 95355-4505 | 2020-03-06 |
| 1821567645 | Aricka Ream | Counselor | 1704 Groveton Way, Modesto, CA 95355-1904 | 2018-11-21 |
| 1831668466 | Palepa Iulio | Counselor | 3005 Cannon Way Apt A, Modesto, CA 95354-2155 | 2018-11-13 |
| 1104364801 | Catherine Mae Linville | Counselor | 1030 15th St, Modesto, CA 95354-1102 | 2017-02-02 |
| 1417492182 | Chaqulia Anita Ramirez | Counselor | 2020 Standiford Ave # Suitef3, Modesto, CA 95350-6529 | 2017-01-04 |
| 1588061337 | Ashley Boyd | Counselor | 1336 Stonum Rd, Modesto, CA 95351-5121 | 2014-11-21 |
| 1720482136 | Shari Johnson | Counselor | 1517 Panthers Ln, Modesto, CA 95355-9303 | 2014-10-14 |
| 1740579424 | Milissa Ann Catherine-plett | Counselor | 108 Bonita Cir, Modesto, CA 95354-1410 | 2011-04-01 |
| 1205144318 | Brianna Decoteau | Counselor | 916 Mchenry, Modesto, CA 95350 | 2010-09-23 |
| 1508019704 | Lizette Guzman | Counselor | 1130 L St, Modesto, CA 95354-0893 | 2008-10-31 |
| Find all providers in MODESTO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.