MISS JODY LYNN PENNYCOOK PA
NPI 1255696910
Physician Assistant - Medical in Santa Rosa, CA

Active since July 09, 2012
4740 HOEN AVE, SANTA ROSA, CA 95405(707) 542-2783(707) 542-7976 Get Directions Write a Review

NPPES record last updated: July 9, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Miss Jody Lynn Pennycook Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MISS JODY LYNN PENNYCOOK PA (NPI 1255696910) is an individual medical provider in Santa Rosa, California, licensed in California (PA22225) and active in the NPI registry since July 2012.

NPPES Registry Identity

NPI1255696910
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameMISS JODY LYNN PENNYCOOKCredential: PA
Location Address4740 HOEN AVESanta Rosa, CA 95405-7824
Mailing Address4740 Hoen AveSanta Rosa, CA 95405-7824 · (707) 542-2783 · Fax (707) 542-7976
Fax(707) 542-7976
Sole ProprietorYes
Enumeration DateJuly 9, 2012
NPI 1255696910 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License Licensed in CA · PA22225
4740 HOEN AVE, Santa Rosa, CA 95405

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Internal Medicine (Cardiovascular Disease)
4740 HOEN AVE
SANTA ROSA, CA 95405
Internal Medicine (Cardiovascular Disease)
4740 HOEN AVE
SANTA ROSA, CA 95405
Internal Medicine (Cardiovascular Disease)
4740 HOEN AVE
SANTA ROSA, CA 95405
Nuclear Medicine (Nuclear Imaging & Therapy)
4740 HOEN AVE, SUITE B
SANTA ROSA, CA 95405

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jody Pennycook's NPI number?

The NPI number for Jody Pennycook is 1255696910. It was assigned to this individual provider in the NPPES registry on July 9, 2012.

Where is Jody Pennycook located?

Jody Pennycook practices at 4740 Hoen Ave, Santa Rosa, CA 95405. The listed phone number is (707) 542-2783.

What is Jody Pennycook's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

When was this NPI record last updated?

The NPPES record for Jody Pennycook was last updated on July 9, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.