Provider Demographics
NPI:1215574835
Name:PENNOYER, WREN HENRY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:WREN
Middle Name:HENRY
Last Name:PENNOYER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:JESSECA
Other - Middle Name:LAUREN
Other - Last Name:PENNOYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:PO BOX 3111
Mailing Address - Street 2:
Mailing Address - City:FORT DEFIANCE
Mailing Address - State:AZ
Mailing Address - Zip Code:86504-3111
Mailing Address - Country:US
Mailing Address - Phone:858-922-2817
Mailing Address - Fax:
Practice Address - Street 1:160 COUNTRY CLUB GATE CTR
Practice Address - Street 2:
Practice Address - City:PACIFIC GROVE
Practice Address - State:CA
Practice Address - Zip Code:93950-5022
Practice Address - Country:US
Practice Address - Phone:831-373-8323
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-02
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS024269183500000X
CARPH81427183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist