Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Tararoth Pen Keo

Individual provider Family Nurse Practitioner · NPI 1205689783

Tararoth Pen Keo is a Nurse Practitioner in Lancaster, California. Qualified in 2024, 2 years ago. Practices with Unified Health Associates, an 11-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
2
Licensed in
CA
In the registry since
2024

Practice location Address checks out

43932 15th St W Ste 103
Lancaster, CA 93534-5234
Phone: (661) 945-7755
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 95029648 (CA)

Record details

NPI number1205689783
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedApril 8, 2024
Last updated in NPPESApril 8, 2024
Certification dateApril 6, 2024
Mailing address1134 Brianna Ave, Lancaster, CA 93535-2931

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Unified Health Associates — 11 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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