JODY LYNN ULLOM MD
NPI 1417916990
Pediatrics in San Rafael, CA

Q: What is Jody Ullom's NPI number?

The NPI number for Jody Ullom is 1417916990. It was assigned to this individual provider in the NPPES registry on March 22, 2006.

Q: What is Jody Ullom's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Jody Ullom was last updated on May 18, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.

Active since March 22, 2006

1004 NORTHGATE DR, SAN RAFAEL, CA 94903(415) 590-6150(415) 578-3118 Get Directions Write a Review

NPPES record last updated: May 18, 2016. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Jody Lynn Ullom Md NPPES

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

JODY LYNN ULLOM MD (NPI 1417916990) is an individual pediatrics provider in San Rafael, California, licensed in California (G77729) and active in the NPI registry since March 2006.

NPPES Registry Identity

NPI1417916990

Entity TypeIndividualFemale

Primary Taxonomy208000000X

Provider Legal NameJODY LYNN ULLOMCredential: MD

Location Address1004 NORTHGATE DRSan Rafael, CA 94903-2502

Mailing Address1004 Northgate DrSan Rafael, CA 94903-2502 · (415) 590-6150 · Fax (415) 578-3118

Phone(415) 590-6150

Fax(415) 578-3118

Sole ProprietorNo

Enumeration DateMarch 22, 2006

Last NPPES UpdateMay 18, 2016

✔ NPI 1417916990 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in CA · G77729

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

1004 NORTHGATE DR, San Rafael, CA 94903

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Other Providers at the Same Location NPPES 15

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

MRS. CHRISTINE ROSE HODGSON PNP

Nurse Practitioner (Pediatrics)