Jeffrey Penner, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

7094 Issued in CA

Practice address

8885 Rio San Diego Dr
Suite 325
San Diego, CA 92108-1624

Phone

(619) 297-8640

Fax

(619) 297-0122

NPI assigned

Oct 2, 2012

Sex

Male

Sole proprietor

Yes

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Jennifer L. Piper Psychologist, Inc.

  • Clinical Psychologist
  • San Diego, CA
  • NPI 1437898889
  NPD (past)
• Meg Lawrence, M.D., a.P.C.

  • Pediatrics Physician
  • San Diego, CA
  • NPI 1477646701
  NPD (past)
• Trails Therapy, a Psychological Corporation

  • Psychologist
  • San Diego, CA
  • NPI 1578135935
  NPD (past)

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

{
    "created_epoch": "1349136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349136000000",
    "number": "1104178078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8885 RIO SAN DIEGO DR",
            "address_2": "SUITE 325",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921081624",
            "telephone_number": "619-297-8640",
            "fax_number": "619-297-0122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8885 RIO SAN DIEGO DR",
            "address_2": "SUITE 325",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921081624",
            "telephone_number": "619-297-8640",
            "fax_number": "619-297-0122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNER",
        "first_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-10-02",
        "last_updated": "2012-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "7094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zaniecia Penn
• Michael Andre Penna
• Laura Pennelle, LCSW, JD
• Andrew Warren Penner, B.A.
• Gretchen Penner
• Nicholas Penner, M.D.
• Nicollette Penner, DPT
• Angela Mariya Penney
• Judith Ann Penniman, LCSW
• Katherine Rae Penninga

• Clinical Psychologist in San Diego, CA
• Providers in San Diego, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.