Ryan Pepin

Primary specialty

School PsychologistTaxonomy code 103TS0200X

License

210189066 Issued in CA

Practice address

1300 Valley House Dr
Rohnert Park, CA 94928-4927

Phone

(707) 794-6016

NPI assigned

Aug 25, 2025

Last updated

Aug 25, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1756080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756080000000",
    "number": "1053299230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 VALLEY HOUSE DR STE 100",
            "city": "ROHNERT PARK",
            "state": "CA",
            "postal_code": "949284931",
            "telephone_number": "707-794-6016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 VALLEY HOUSE DR",
            "city": "ROHNERT PARK",
            "state": "CA",
            "postal_code": "949284927",
            "telephone_number": "707-794-6016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEPIN",
        "first_name": "RYAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-08-25",
        "last_updated": "2025-08-25",
        "certification_date": "2025-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "CA",
            "license": "210189066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patel and Gill Dental Corporation (Rohnert Park Smiles Dentistry)
• Neal Patel, D.D.S.
• Paula Shadid, O.D.
• Paula Pelavin, P.A.
• Nicole Lynn Penney
• Emily Perez, RN, IBCLC
• Petaluma Health Center Inc (Rohnert Park Health Center)
• Petaluma Health Center, Inc (Rohnert Park Community Acupuncture)
• Petaluma Health Center, Inc. (Rohnert Park Health Center Pharmacy)
• Tanner Petersen

• School Psychologist in Rohnert Park, CA
• Providers in Rohnert Park, CA by specialty
• School Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.