MISS JODY LYNN PENNYCOOK (NPI# 1255696910) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255696910 |
| Entity Type | Individual |
| Full Name | MISS JODY LYNN PENNYCOOK |
| Credential | PA |
| Practice Address |
4740 Hoen Ave Santa Rosa CA 95405-7824 |
| Practice Telephone | 7075422783 |
| Practice Fax Number | 7075427976 |
| Mailing Telephone | 7075422783 |
| Mailing Fax Number | 7075427976 |
| Enumeration Date | 2012-07-09 |
| Last Update Date | 2012-07-09 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA22225 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4740 HOEN AVE |
| City | SANTA ROSA |
| State | CA |
| Zip Code | 95405-7824 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811074586 | Sanjay Chamanlal Dhar | Internal Medicine | 4740 Hoen Ave, Santa Rosa, CA 95405-7824 | 2006-11-01 |
| 1114099884 | North Bay Cardiology Inc. | Internal Medicine | 4740 Hoen Ave, Santa Rosa, CA 95405-7824 | 2006-11-15 |
| 1821160599 | Stephen Wayne Halpern | Internal Medicine | 4740 Hoen Ave, Santa Rosa, CA 95405-7824 | 2006-11-15 |
| 1881771566 | North Bay Cardiac Imaging Inc | Nuclear Medicine | 4740 Hoen Ave, Suite B, Santa Rosa, CA 95405-7824 | 2006-11-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083230486 | Lizett Camacho | Counselor | 145o Neotomas Avenue Suite 200, Santa Rosa, CA 95405 | 2020-06-22 |
| 1346768918 | Ingrid Tsong | Student in an Organized Health Care Education/Training Program | 3447 Summerfield Road, Santa Rosa, CA 95405 | 2017-09-05 |
| 1275051898 | Jessica Peters Malmberg | Student in an Organized Health Care Education/Training Program | 2447 Summerfield Rd, Santa Rosa, CA 95405 | 2017-09-04 |
| 1306246772 | Kirsten Eckert | Advanced Practice Midwife | 500 Doyle Park Dr Suite 103, Santa Rosa, CA 95405 | 2014-09-03 |
| 1982034294 | Mohammad Reza Saeidi | Dentist | 1820 Sonoma Ave Ste 90a, Santa Rosa, CA 95405 | 2013-11-22 |
| 1851631642 | Debi M. Emmons | Marriage & Family Therapist | 2447 Summerfield Dr, Social Advocates for Youth, Santa Rosa, CA 95405 | 2013-02-15 |
| 1841549979 | Karie Louise Klim | Marriage & Family Therapist | 182 Farmers Ln Ste 204, Santa Rosa, CA 95405 | 2012-09-05 |
| 1427314400 | Rachel E. Page | Counselor | 2447 Summerfield Rd., Santa Rosa, CA 95405 | 2012-04-04 |
| 1689991572 | Center for Integral Healing Inc. | Community Health Worker | 182 Farmers Lane, #203, Santa Rosa, CA 95405 | 2010-04-30 |
| 1588997647 | Kai Morgan | Dentist | 1144 Suite 116 Soonoma Ave, Santa Rosa, CA 95405 | 2009-09-08 |
| Find all providers in zip 95405 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467096149 | Brittany Griffin | Physician Assistant | 208 Concourse Blvd # 1, Santa Rosa, CA 95403-8210 | 2019-11-05 |
| 1922301522 | Alexandra Maya Mcspadden | Physician Assistant | 3333 Mendocino Avenue Suite 130, Kaiser Permanente Cosmetic Services, Santa Rosa, CA 95403 | 2010-12-21 |
| 1821058140 | Patty Lynn Tucker | Physician Assistant | 585 W College Ave, Santa Rosa, CA 95401-5000 | 2006-03-23 |
| 1760089635 | Christopher Andrew Rhule | Physician Assistant | 1551 Pacific Ave, Santa Rosa, CA 95404-3568 | 2020-10-05 |
| 1538662937 | Paul Viscogliosi | Physician Assistant | 3883 Airway Dr Ste 165, Santa Rosa, CA 95403-1675 | 2018-03-12 |
| 1619404431 | Atoosa Molanazadeh | Physician Assistant | 1165 Montgomery Dr, Santa Rosa, CA 95405-4801 | 2017-05-11 |
| 1467889451 | Angela Merrisa Wetmore | Physician Assistant | 585 W College Ave Ste A, Santa Rosa, CA 95401-5060 | 2013-10-04 |
| 1104101401 | Luis E Garcia | Physician Assistant | 208 Concourse Blvd, Santa Rosa, CA 95403-8210 | 2011-10-18 |
| 1316176712 | Lesley M Field | Physician Assistant | 121 Sotoyome St, Santa Rosa, CA 95405-4823 | 2009-07-07 |
| 1417172495 | Jill R. Ringer | Physician Assistant | 34 Mark West Springs Rd Fl 2, Santa Rosa, CA 95403 | 2007-04-16 |
| Find all providers in SANTA ROSA | ||||
| City | SANTA ROSA |
| Zip Code | 95405 |
Please comment or provide details below to improve the information on MISS JODY LYNN PENNYCOOK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.