# MRS. JESSICA SUSANA RIDAO PENAFLOR

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1063867380
- **Gender:** F
- **Credential:** AGNP-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 95004141 | CA | — |
| 363LA2200X | Adult Health Nurse Practitioner | 95004141 | CA | — |
| 363LG0600X | Gerontology Nurse Practitioner | 95004141 | CA | Yes |
| 363LP2300X | Primary Care Nurse Practitioner | 95004141 | CA | — |

## Other

- **Enumeration date:** 04/25/2016
- **Last updated:** 09/08/2026