PHONMANY PHENGPHAVONG
NPI 1043849847
Licensed Vocational Nurse in Perris, CA

Q: What is the provider's specialty?

The provider's specialty is Licensed Vocational Nurse with taxonomy code 164X00000X.

Active since April 03, 2020

1688 N PERRIS BLVD, PERRIS, CA 92571(951) 443-2200 Get Directions Write a Review

NPPES record last updated: April 3, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

On this page

About Phonmany Phengphavong NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PHONMANY PHENGPHAVONG (NPI 1043849847) is an individual licensed vocational nurse in Perris, California, licensed in California (287603) and active in the NPI registry since April 2020.

NPPES Registry Identity

NPI1043849847

Entity TypeIndividualFemale

Primary Taxonomy164X00000X

Provider Legal NamePHONMANY PHENGPHAVONG

Location Address1688 N PERRIS BLVDPerris, CA 92571-4709

Mailing Address2982 Bautista StRiverside, CA 92506-4293 · (951) 224-2620

Phone(951) 443-2200

Sole ProprietorYes

Enumeration DateApril 3, 2020

NPPES CertifiedApril 3, 2020

✔ NPI 1043849847 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLicensed Vocational NurseNursing Service Providers

Taxonomy Code164X00000X

License✔ Licensed in CA · 287603

Definition

A licensed vocational nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. [An alternate term for licensed practical nurse arising from difference in occupational titles between states and post-high school training programs and institutions.] Requirements for education, experience, licensure, and job responsibilities vary among the states.

1688 N PERRIS BLVD, Perris, CA 92571

Open in Google Maps ↗