PENNY R. VANDESTREEK DO, INC. (NPI# 1558540526) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1558540526 |
Entity Type | Organization |
Organization Name | PENNY R. VANDESTREEK DO, INC. |
Practice Address |
1 Medical Plaza Dr Att Nuclear Medicine Roseville CA 95661-3037 |
Mailing Address |
Po Box 1328 Rocklin CA 95677-7328 |
Practice Telephone | 9167811292 |
Practice Fax Number | 9166639912 |
Mailing Telephone | 9167811292 |
Mailing Fax Number | 9166639912 |
Enumeration Date | 2007-10-26 |
Last Update Date | 2008-06-30 |
Authorized Official Name | PENNY R VANDESTREEK (PRESIDENT) |
Authorized Official Telephone | 9167811292 |
Authorized Official Credential | DO |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207UN0902X |
Nuclear Medicine Specialization: Nuclear Imaging & Therapy |
20A6232 | CA | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
RAILROAD MEDICARE | P00017739 | 01 | |
CA | 00AX62320 | 05 |
Street Address |
1 MEDICAL PLAZA DR ATT NUCLEAR MEDICINE |
City | ROSEVILLE |
State | CA |
Zip Code | 95661-3037 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1578560389 | Angela Bell | Emergency Medicine | 1 Medical Plaza Dr, Department of Emergency Medicine, Roseville, CA 95661-3037 | 2005-07-07 |
1942814744 | Steven Michael Decristofaro | Counselor | 1 Medical Plaza Dr, Roseville, CA 95661-3037 | 2020-08-31 |
1083228886 | Dawn K Krakover | Counselor | 1 Medical Plaza Dr, Roseville, CA 95661-3037 | 2020-08-31 |
1659900579 | Lacy Danielle Couchot | Nurse's Aide | 1 Medical Plaza Dr, Roseville, CA 95661-3037 | 2020-04-02 |
1326670571 | Veronica Marie Kennedy | Marriage & Family Therapist | 1 Medical Plaza Dr, Roseville, CA 95661-3037 | 2020-02-05 |
1417595760 | William Murray | Physician Assistant | 1 Medical Plaza Dr, Roseville, CA 95661-3037 | 2019-12-17 |
1649813015 | Jennifer Eloise Amaro | Social Worker | 1 Medical Plaza Dr, Roseville, CA 95661-3037 | 2019-10-17 |
1851959720 | Kyi Zin M.d.,inc. | Internal Medicine | 1 Medical Plaza Dr, Roseville, CA 95661-3037 | 2019-06-04 |
1730613951 | Benjamin Palmer | Internal Medicine | 1 Medical Plaza Dr, Roseville, CA 95661-3037 | 2017-04-13 |
1467812800 | Mitchell Morta | Nurse Practitioner | 1 Medical Plaza Dr, Roseville, CA 95661-3037 | 2016-02-27 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1134777816 | Aprildawn Mccarty Mccarty | Behavior Technician | 2125 Professional Dr, 100, Roseville, CA 95661 | 2019-08-27 |
1407409089 | David Armel Gomez Croddy | Dentist | 2740 Carradale Drive, Roseville, CA 95661 | 2019-07-22 |
1699335612 | Mowell | Durable Medical Equipment & Medical Supplies | 901 Sunrise, Roseville, CA 95661 | 2019-06-20 |
1578024998 | Mystesia Lasan Hayes | Behavior Technician | 4121 Vittorio Dr., Roseville, CA 95661 | 2019-03-28 |
1033676457 | The Place Within | Counselor | 720 Sunrise Ave #d115, Roseville, CO 95661 | 2019-02-21 |
1396217733 | Tuyen Thi Thanh Nguyen | Respiratory Therapist, Registered | Kaiser Roseville Hospital, 1600 Eureka Rd, Roseville, CA 95661 | 2018-12-26 |
1982179776 | Dr. Jeffrey A. Saladin, Dental Corporation | Dentist | 1565 Eureka Road, Suite 5, Roseville, CA 95661 | 2018-10-08 |
1184106536 | Sabita Kondle | Marriage & Family Therapist | 1528 Hope Counseling Center Ste 101, Roseville, CA 95661 | 2018-09-02 |
1740787837 | Sylvia A Atieno | Nurse Practitioner | Suttter Roseville Medical Center, 1 Medical Plaza, Roseville, CA 95661 | 2018-04-06 |
1457875296 | Good Works Psychophysiology and Physical Therapy | Physical Therapist | 1650 Leadhill Blvd, 600, Roseville, CA 95661 | 2017-08-02 |
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Taxonomy Code | 207UN0902X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Nuclear Medicine |
Specialization | Nuclear Imaging & Therapy |
A nuclear medicine physician who specializes in nuclear imaging and therapy. |
Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) was, but is no longer issued by the American Osteopathic Board of Nuclear Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1154500122 | Fred Weiland Md, Inc | Nuclear Medicine | 1 Medical Plaza Dr, Att Nuclear Medicine, Roseville, CA 95661-3037 | 2007-10-26 |
1164463402 | Penny Robillard Vandestreek | Nuclear Medicine | 1 Medical Plaza Dr, Att: Nuclear Medicine, Roseville, CA 95661-3037 | 2006-06-09 |
1508805722 | Frederick Leo Weiland | Nuclear Medicine | 1 Medical Plaza Dr, Att: Nuclear Medicine, Roseville, CA 95661-3037 | 2006-06-05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1992130439 | Thomas Francis Budinger | Nuclear Medicine | 966 Euclid Ave, Berkeley, CA 94708-1436 | 2013-09-03 |
1891063020 | Zaman Javaheri | Nuclear Medicine | 14561 Curry Ct, Auburn, CA 95602-8488 | 2011-12-02 |
1750680302 | Nova M Isaac | Nuclear Medicine | 300 Pasteur Dr Rm H2200, Stanford, CA 94305-5281 | 2011-03-22 |
1578731808 | Hemet Kherbache | Nuclear Medicine | 557 E Cypress Ave Apt G, Burbank, CA 91501-3201 | 2008-02-20 |
1316124662 | Maria Rita Guevara | Nuclear Medicine | 12253 Dehougne St, North Hollywood, CA 91605-5611 | 2008-01-29 |
1003938473 | West Coast Radiology Center, Inc | Nuclear Medicine | 1100-a N. Tustin Avenue, Santa Ana, CA 92705 | 2007-04-04 |
1316061674 | Ali Abaian | Nuclear Medicine | 8460 S Central Ave, Los Angeles, CA 90001-3761 | 2007-03-19 |
1194825703 | David J. Rossman | Nuclear Medicine | 5395 Ruffin Rd Ste 202, San Diego, CA 92123-1338 | 2006-09-24 |
1568478436 | Brian Keith Gamble | Nuclear Medicine | 10701 Riverside Dr, Suite 16, Toluca Lake, CA 91602-2384 | 2006-07-31 |
1306892195 | Molecular Imaging Management LLC. | Nuclear Medicine | 12524 W Washington Blvd, 12524 W. Washington Blvd, Los Angeles, CA 90066-5506 | 2006-05-25 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.