MEDICARE: PENUEL ACCESS CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1306793765
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PENUEL ACCESS CARE LLC

Provider Business Mailing Address
First Line	:	19849 NORDHOFF ST
Second Line	:
City	:	NORTHRIDGE
State	:	CA
Zip	:	91324-3331
Country	:	US
Telephone Number	:	818-442-8413
Fax Number	:

Provider Business Practice Location Address
First Line	:	19849 NORDHOFF ST
Second Line	:
City	:	NORTHRIDGE
State	:	CA
Zip	:	91324-3331
Country	:	US
Telephone Number	:	818-442-8413
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER/CEO
Name	:	REGAN RACIMO
Credential	:
Telephone Number	:	818-207-4808

Provider Enumeration Date	:	03/14/2026
Last Update Date	:	03/14/2026

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