MISS JODY LYNN PENNYCOOK PA NPI 1255696910

NPI Information

NPI: 1255696910
Provider Name: MISS JODY LYNN PENNYCOOK, PA
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
4740 HOEN AVE
SANTA ROSA, CA
ZIP 95405
Phone: (707) 542-2783
Get Directions

MISS Jody Lynn Pennycook, PA is a medical physician assistant in Santa Rosa, CA. MISS Jody Lynn Pennycook, PA NPI is 1255696910. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4740 HOEN AVE
SANTA ROSA, CA
ZIP 95405-824
Phone: (707) 542-2783
Fax: (707) 542-7976

The NPI 1255696910 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/9/2012 and was last updated on 7/9/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	PA22225	CALIFORNIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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