MS. JENNIFER RUTH PETTIBONE RN
NPI 1003004474
Registered Nurse - Psychiatric/Mental Health in Fairfield, CA

NPI Status: Active since October 10, 2007

Contact Information

2101 COURAGE DR
MS-10-200
FAIRFIELD, CA
ZIP 94533
Phone: (707) 784-2154

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  • Individual
  • Female
  • Registered Nurse
  • Psychiatric/Mental Health

About JENNIFER PETTIBONE

Jennifer Pettibone is a provider established in Fairfield, California and her medical specialization is Registered Nurse with a focus in psychiatric/mental health . The healthcare provider is registered in the NPI registry with number 1003004474 assigned on October 2007. The practitioner's primary taxonomy code is 163WP0808X with license number 464317 (CA). The provider is registered as an individual and her NPI record was last updated 17 years ago.

NPI1003004474
Provider NameMS. JENNIFER RUTH PETTIBONE RN
Location Address2101 COURAGE DR MS-10-200 FAIRFIELD, CA 94533
Location Phone(707) 784-2154
Mailing Address1048 2ND ST APT 6 NOVATO, CA 94945
GenderFemale
Entity TypeIndividual
Is Sole Proprietor?No
Enumeration Date10-10-2007
Last Update Date10-10-2007
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A registered nurse (RN) like Jennifer Pettibone coordinates and provides patient care and educates patients about various health conditions. Registered nurses give advice and emotional support to patients and their families. The typical duties of a registered nurse include: assessing patient conditions, record medical histories and symptoms, observe patients and record the observations, administer medicines and treatments, consult and collaborate with doctors, operate and monitor medical equipment, teach patients and families how to manage injuries or illnesses, etc.

Registered nurses typically work as part of a team with physicians and other healthcare professionals. In some medical teams registered nurses supervise nursing assistants, licensed practical nurses, and home health aides.

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Registered Nurse Psychiatric/Mental Health

Taxonomy Code
163WP0808X
Type
Nursing Service Providers
License No.
464317
License State
CA

Location Map

Mailing Address

1048 2ND ST APT 6
NOVATO, CA
ZIP 94945
Phone: (415) 897-1899

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1003004474
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2003008414
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 0 + 3 + 0 + 0 + 8 + 4 + 1 + 4 + 24 = 46
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
50 - 46 = 44

The NPI number 1003004474 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1396736732MS. SARAH JANE BOLGER RNP
Individual
Nurse Practitioner (Family)2101 COURAGE DR
FAIRFIELD, CA 94533
(707) 784-2048
1851327316MRS. SARAH KATHERINE LAYE M.S., R.D.
Individual
Dietitian, Registered2101 COURAGE DR MS 10-100, SCH AND SS
FAIRFIELD, CA 94533
(707) 435-2213
1235244294 HOMAYOUN FAGHIHI-SHIRAZI M.D.
Individual
Psychiatry & Neurology (Psychiatry)2101 COURAGE DR
FAIRFIELD, CA 94533
(707) 435-2077
1821103730DR. RAYMOND M. REYES M.D.
Individual
Psychiatry & Neurology (Psychiatry)2101 COURAGE DR BOX 4090, MAIL STATION 10-300
FAIRFIELD, CA 94533
(707) 435-2080
1811087232MISS ANNA MARIE ANTONIO FNP
Individual
Nurse Practitioner (Family)2101 COURAGE DR
FAIRFIELD, CA 94533
(707) 784-2010
1427139864DR. LAURIE MATIASEVICH DDS
Individual
Dentist (Dental Public Health)2101 COURAGE DR
FAIRFIELD, CA 94533
(707) 784-2120
1447336508TELECARE CORPORATION
Organization
Psychiatric Hospital2101 COURAGE DR
FAIRFIELD, CA 94533
(707) 784-2130
1336208784 KELLIE MARIE KEKKI LCSW
Individual
Social Worker (Clinical)2101 COURAGE DR MS 10-100
FAIRFIELD, CA 94533
(707) 784-2010
1992865224 CARRIE BERNICE BLOOM
Individual
Counselor (Mental Health)2101 COURAGE DR
FAIRFIELD, CA 94533
(707) 784-2140
1023178308MS. CYNTHIA LYNN BOTT LCSW
Individual
Social Worker (Clinical)2101 COURAGE DR
FAIRFIELD, CA 94533
(707) 784-2140
1518027309 KATHY DEMAGGIO RD
Individual
Dietitian, Registered2101 COURAGE DR NUTRITION, MS 10-100
FAIRFIELD, CA 94533
(707) 784-2216
1083774814MS. MICHELLE GERSON MFT
Individual
Marriage & Family Therapist2101 COURAGE DR
FAIRFIELD, CA 94533
(707) 784-2070
1346300480 PRISCILLA MARIA DE LEON
Individual
Counselor (Mental Health)2101 COURAGE DR
FAIRFIELD, CA 94533
(707) 784-2140
1306906474 LEO HELMUTH SADDAM RN
Individual
Registered Nurse (Psychiatric/Mental Health)2101 COURAGE DR
FAIRFIELD, CA 94533
(707) 784-2101
1013078948MS. MELANIE DAWN COOK MFT
Individual
Marriage & Family Therapist2101 COURAGE DR
FAIRFIELD, CA 94533
(707) 784-2152
1124189857 ERNESTINA A. MENDOZA MFTI
Individual
Marriage & Family Therapist2101 COURAGE DR
FAIRFIELD, CA 94533
(707) 784-2163
1023179645MS. CIELO LUCIA SCHAUGAARD
Individual
Counselor (Mental Health)2101 COURAGE DR
FAIRFIELD, CA 94533
(707) 784-2140
1073674974 ROXANNE JOHNSON PATERNO L.C.S.W.
Individual
Social Worker (Clinical)2101 COURAGE DR MAIL STATION 10-300
FAIRFIELD, CA 94533
(707) 784-2150
1417018326 LAWRENCE L. STENTZEL III MFT
Individual
Marriage & Family Therapist2101 COURAGE DR
FAIRFIELD, CA 94533
(707) 784-2061
1487715397MS. KARAN DEBORAH POST MFT
Individual
Marriage & Family Therapist2101 COURAGE DR
FAIRFIELD, CA 94533
(707) 784-2052

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1003004474, enumerated in the NPI registry as an "individual" on October 10, 2007

The provider is located at 2101 Courage Dr Ms-10-200 Fairfield, Ca 94533 and the phone number is (707) 784-2154

The provider's speciality is Registered Nurse with taxonomy code 163WP0808X with a focus in Psychiatric/Mental Health

This NPI record was last updated on October 10, 2007. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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