Jay Pennock, MD a Professional Corporation

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

JAY PENNOCK, MD A PROFESSIONAL CORPORATION

Practice address

1595 38TH Ave
Capitola, CA 95010-2901

Phone

(831) 226-2108

NPI assigned

Oct 12, 2006

Organization subpart

No

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

Authorized official

Name

Jay Pennock, MD

Title

Owner and President

Phone

(831) 226-2108

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747612800000",
    "number": "1114016789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1840 41ST AVE STE 102-325",
            "city": "CAPITOLA",
            "state": "CA",
            "postal_code": "950102513",
            "telephone_number": "831-345-0652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1595 38TH AVE",
            "city": "CAPITOLA",
            "state": "CA",
            "postal_code": "950102901",
            "telephone_number": "831-226-2108"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "901 Soquel Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Santa Cruz",
            "state": "CA",
            "postal_code": "950622122",
            "country_code": "US",
            "telephone_number": "831-345-0652",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "104 Whispering Pines Dr Ste 105A",
            "address_purpose": "LOCATION",
            "city": "Scotts Valley",
            "state": "CA",
            "postal_code": "950664799",
            "country_code": "US",
            "telephone_number": "831-345-0652",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JAY PENNOCK, MD A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2025-05-19",
        "certification_date": "2025-05-19",
        "status": "A",
        "authorized_official_last_name": "PENNOCK",
        "authorized_official_first_name": "JAY",
        "authorized_official_title_or_position": "OWNER AND PRESIDENT",
        "authorized_official_telephone_number": "831-226-2108",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Capitola, CA
• Providers in Capitola, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 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.