JACK O'DEA
NPI 1548934110
Student in an Organized Health Care Education/Training Program in Santa Rosa, CA

Q: What is Jack O'dea's NPI number?

The NPI number for Jack O'dea is 1548934110. It was assigned to this individual provider in the NPPES registry on August 5, 2021.

Q: What is Jack O'dea's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Jack O'dea was last updated on August 6, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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 August 05, 2021

2447 SUMMERFIELD RD, SANTA ROSA, CA 95405(707) 544-3299 Get Directions Write a Review

NPPES record last updated: August 6, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Jack O'dea NPPES

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

JACK O'DEA (NPI 1548934110) is an individual student in an organized health care education/training program in Santa Rosa, California and active in the NPI registry since August 2021.

NPPES Registry Identity

NPI1548934110

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameJACK O'DEA

Location Address2447 SUMMERFIELD RDSanta Rosa, CA 95405-7815

Mailing Address2447 Summerfield RdSanta Rosa, CA 95405-7815 · (707) 544-3299

Phone(707) 544-3299

Sole ProprietorNo

Enumeration DateAugust 5, 2021

Last NPPES UpdateAugust 6, 2021

NPPES CertifiedAugust 6, 2021

✔ NPI 1548934110 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

2447 SUMMERFIELD RD, Santa Rosa, CA 95405

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

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