Healthcare Provider Details

I. General information

NPI: 1174456933
Provider Name (Legal Business Name): ASSISTANCE TO SUCCESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2473 BARRY AVE
LOS ANGELES CA
90064-2901
US

IV. Provider business mailing address

2473 BARRY AVE
LOS ANGELES CA
90064-2901
US

V. Phone/Fax

Practice location:
  • Phone: 424-644-5138
  • Fax:
Mailing address:
  • Phone: 424-644-5138
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name: NIESHA BROWN PENNELL
Title or Position: CEO
Credential:
Phone: 424-644-5138