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General NPI Number Information
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NPI Number | 1740331644
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Entity Type | Individual
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Provider Name | PATRICIA ANN PENN PHD
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Gender | Female
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3880 S BASCOM AVE SUITE 212,
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City | SAN JOSE
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State | CA
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Zip | 95124-2674
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Country | US
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Telephone | 408-377-1200
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Fax | 408-377-7833
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Provider Business Mailing Address
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Address Line | 3880 S. BASCOM AVE., SUITE 212,
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City | SAN JOSE
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State | CA
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Zip | 95124-2675
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Country | US
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Telephone | 408-377-1200
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Fax | 408-377-7833
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCS11694
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License Number State | CA
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