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

Tommy Phoukhaothong Panyanouvong

Individual provider Adult Companion · NPI 1407126469

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 Ave
Modesto, CA 95351-4821
Phone: (209) 541-0662
Show map & directions

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 number1407126469
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJanuary 9, 2012
Last updated in NPPESMay 21, 2025
Certification dateMay 21, 2025

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