Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jody Lynn Ullom, MD

Individual provider Pediatrics Physician · NPI 1417916990

Jody Lynn Ullom, MD is a Pediatrics Physician in San Rafael, California. Licensed in California. Registered with an NPI since 2006.

Licensed in
CA
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1004 Northgate Dr
San Rafael, CA 94903-2502
Phone: (415) 590-6150
Fax: (415) 578-3118
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence G77729 (CA)

Record details

NPI number1417916990
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 22, 2006
Last updated in NPPESMay 18, 2016

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