Jennifer L Penney, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY 22358 Issued in CA

Practice address

4361 Railroad Ave
Pleasanton, CA 94566-6611

Phone

(925) 201-6224

NPI assigned

Mar 29, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jennifer L Vayder Former name

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, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Axis Community Health IncGroup PAC ID 7012975071, 39 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Axis Community Health Inc

  • Federally Qualified Health Center (FQHC)
  • Pleasanton, CA
  • NPI 1376760546
  Medicare reassignment Care Compare group NPD
• Axis Community Health Inc

  • Federally Qualified Health Center (FQHC)
  • Pleasanton, CA
  • NPI 1336366509
  NPD
• Axis Community Health Inc

  • Federally Qualified Health Center (FQHC)
  • Livermore, CA
  • NPI 1336990506
  NPD

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381363200000",
    "number": "1396865952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4361 RAILROAD AVE",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945666611",
            "telephone_number": "925-201-6224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4361 RAILROAD AVE",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945666611",
            "telephone_number": "925-201-6224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNEY",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2013-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY 22358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "VAYDER",
            "middle_name": "L",
            "credential": "MA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Annalissa Lorena Dalan Pena, NP
• Dolor Mia Pena, RN
• Zaira Penaloza, OTR/L
• Cynthia Sue Penn-Duecker, MD
• Barry J. Penner, D.D.S.
• People First Transit LLC
• Jessica Peralta Meza
• Jenifer Pereira-Weiss, LMFT
• Eduardo Pereira
• Cinthia Perez Grijalva

• Psychologist in Pleasanton, CA
• Providers in Pleasanton, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2013; 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.