Healthcare Provider Details

I. General information

NPI: 1275401721
Provider Name (Legal Business Name): TYNESHA PENNY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2025
Last Update Date: 12/20/2025
Certification Date: 12/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2945 TOWNSGATE RD STE 200
WESTLAKE VILLAGE CA
91361-5866
US

IV. Provider business mailing address

2945 TOWNSGATE RD STE 200
WESTLAKE VILLAGE CA
91361-5866
US

V. Phone/Fax

Practice location:
  • Phone: 805-342-0222
  • Fax: 805-480-4965
Mailing address:
  • Phone: 805-342-0222
  • Fax: 805-480-4965

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT155658
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: