JACK PENNELL FISH
NPI 1417753963
Day Training/Habilitation Specialist in San Francisco, CA

Q: What is the provider's specialty?

The provider's specialty is Day Training/Habilitation Specialist with taxonomy code 373H00000X.

Active since February 24, 2025

368 FELL ST, SAN FRANCISCO, CA 94102(415) 861-0828 Get Directions Write a Review

NPPES record last updated: August 15, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Aug 15, 2025, Feb 24, 2025 (2 updates tracked since 2025).

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About Jack Pennell Fish NPPES

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

JACK PENNELL FISH (NPI 1417753963) is an individual day training/habilitation specialist in San Francisco, California and active in the NPI registry since February 2025.

NPPES Registry Identity

NPI1417753963

Entity TypeIndividualMale

Primary Taxonomy373H00000X

Provider Legal NameJACK PENNELL FISH

Location Address368 FELL STSan Francisco, CA 94102-5144

Mailing Address368 Fell StSan Francisco, CA 94102-5144 · (415) 861-0828

Phone(415) 861-0828

Sole ProprietorNo

Enumeration DateFebruary 24, 2025

Last NPPES UpdateAugust 15, 20252 updates tracked since enumeration

NPPES CertifiedAugust 15, 2025

✔ NPI 1417753963 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDay Training/Habilitation SpecialistNursing Service Related Providers

Taxonomy Code373H00000X

Definition

Individuals experienced or trained in working with developmentally disabled individuals who need assistance in acquiring and maintaining life skills that enable them to cope more effectively with the demands of independent living.

Also ListedCommunity Health WorkerTaxonomy 172V00000X

368 FELL ST, San Francisco, CA 94102

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