Tommy Phoukhaothong Panyanouvong
Tommy Phoukhaothong Panyanouvong is an Adult Companion in Modesto, California. Licensed in California. Registered with an NPI since 2012.
- Licensed in
- CA
- In the registry since
- 2012
- Specialties on file
- 3
Practice location Address checks out
1300 Payne AveModesto, CA 95351-4821
Phone: (209) 541-0662
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Peer Specialist (primary) | Taxonomy 175T00000X · Licence MPSS-IUXREV (CA) |
|---|---|
| Adult Companion | Taxonomy 372600000X · Licence MPSSIUXREV (CA) |
| Adult Companion | Taxonomy 372600000X · Licence MPSS-IUXREV (CA) |
Record details
| NPI number | 1407126469 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | January 9, 2012 |
| Last updated in NPPES | May 21, 2025 |
| Certification date | May 21, 2025 |
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