MEDICARE: TENNYSON, INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251K00000X	Public Health or Welfare Agency
2	261QH0100X	Health Service Clinic/Center
3	101YM0800X	Mental Health Counselor
4	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1598482184
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TENNYSON, INC.

Provider Business Mailing Address
First Line	:	835 WILSHIRE BLVD STE 500
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90017-2656
Country	:	US
Telephone Number	:	424-403-0363
Fax Number	:

Provider Business Practice Location Address
First Line	:	835 WILSHIRE BLVD STE 500
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90017-2656
Country	:	US
Telephone Number	:	424-403-0363
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MS. JENNA TENNYSON
Credential	:
Telephone Number	:	626-205-7086

Provider Enumeration Date	:	10/24/2022
Last Update Date	:	10/15/2025

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