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Individual

MISS JODY LYNN PENNYCOOK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
4740 HOEN AVE, SANTA ROSA, CA 95405-7824
(707) 542-2783
(707) 542-7976
Mailing address
4740 HOEN AVE, SANTA ROSA, CA 95405-7824
(707) 542-2783
(707) 542-7976

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA22225
CA

Other

Enumeration date
07/09/2012
Last updated
07/09/2012
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