Individual provider · Type 1 NPI

Emily G. Pengelly, PA-C, MD

Student in an Organized Health Care Education/Training Program · Santa Rosa, CA

NPI number 1699072470 Active

Practice location

401 Bicentennial Way
Santa Rosa, CA 95403-2149

Call (707) 495-3732 Map

Mailing address

746 Pattrell Rd
Norwich, VT 05055-9479

Other practice locations

  • 331 Olcott Dr Ste U3, White River Junction, VT 05001-9263 · (802) 295-6132

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant 363A00000XNone listed
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

582 other providers at this address

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About NPI 1699072470

Emily G. Pengelly, PA-C, MD's National Provider Identifier is 1699072470, issued on Feb 14, 2011. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Santa Rosa, CA. The record was last updated on Mar 17, 2024.