PET IMAGING OF SAN JOSE, LLC (NPI# 1629187695) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629187695 |
| Entity Type | Organization |
| Organization Name | PET IMAGING OF SAN JOSE, LLC |
| Practice Address |
2211 Moorpark Ave. Suite 220 San Jose CA 95128-2632 |
| Practice Telephone | 4082978844 |
| Practice Fax Number | 4082978220 |
| Mailing Telephone | 4082978844 |
| Mailing Fax Number | 4082978220 |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. BIJAN FARHANGUI (CEO/PRESIDENT) |
| Authorized Official Telephone | 4082978844 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 6846-43 | CA | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477693513 | Pet Imaging of San Jose, LLC | Clinic/Center | 2211 Moorpark Ave, Suite 220, San Jose, CA 95128-2654 | 2007-02-07 |
| Street Address |
2211 MOORPARK AVE. SUITE 220 |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95128-2632 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982227138 | Ruth Larsen | Social Worker | 850 S. Bascom Avenue, Suite 280, San Jose, CA 95128 | 2020-05-22 |
| 1265067185 | Of Two Minds Psychotherapy | Marriage & Family Therapist | 190 S. Bascom Ave, Ste 130, San Jose, CA 95128 | 2020-03-11 |
| 1982244166 | Cindy Pantoja Escobar | Behavior Technician | 100 O'connor Drive, Suites 21, San Jose, CA 95128 | 2020-01-15 |
| 1104460591 | Katherine Alexandra Misogas | Pharmacist | 777 Turner Dr # 330, San Jose, CA 95128 | 2019-10-29 |
| 1942842216 | Jodie Pierce | Marriage & Family Therapist | 871 Enborg Lane, San Jose, CA 95128 | 2019-10-08 |
| 1003466434 | Dong Mi Cha | Pharmacist | 777 Turner Dr Ste 330, San Jose, CA 95128 | 2019-09-17 |
| 1114571759 | Sleep Well Acupuncture, Inc | Acupuncturist | 1361 S Winchester Blvd Suite 206, San Jose, CA 95128 | 2019-08-01 |
| 1083277677 | Wellocity, Inc | Health Educator | 334 Santana Row, 318, San Jose, CA 95128 | 2019-04-18 |
| 1518428812 | Alexander Diaz | Radiology | 75 South Bascom Ave, San Jose, CA 95128 | 2019-03-28 |
| 1720542103 | Nanci R Price Inc | Chiropractor | 100 O'connor Dr., Ste 27, San Jose, CA 95128 | 2019-01-30 |
| Find all providers in zip 95128 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467965293 | Kathleen Dawn Kraskouskas | Specialist | 541 W Julian St, San Jose, CA 95110-2338 | 2017-11-15 |
| 1861927568 | Crossover Health Medical Group | Specialist | 5601 Great Oaks Pkwy, Bldg 050, San Jose, CA 95119-1003 | 2017-05-01 |
| 1629503255 | Professional Medical Claims Services | Specialist | 5646 Bluegrass Ln, San Jose, CA 95118-3513 | 2017-04-20 |
| 1669873204 | Wendy Ann Brotherton | Specialist | 1401 Parkmoor Ave Ste 230, San Jose, CA 95126-3407 | 2014-09-15 |
| 1225467756 | Ir Solutions Inc | Specialist | 105 N Bascom Ave Ste 104, San Jose, CA 95128-1811 | 2013-11-05 |
| 1558793653 | Angela Dawn Ballou | Specialist | 1052 Delna Manor Ln, San Jose, CA 95128-3457 | 2013-07-31 |
| 1295089670 | Huong Yen Duong | Specialist | 184 Checkers Dr, San Jose, CA 95116-1359 | 2012-11-06 |
| 1407116213 | Cherie Jones | Specialist | 2555 Corde Terra Cir, #331, San Jose, CA 95111-1955 | 2012-05-25 |
| 1215294129 | Nguyen Tan | Specialist | 110 Jackson St, San Jose, CA 95112-5105 | 2012-04-16 |
| 1447522602 | Daniela Bayer | Specialist | 560 S Winchester Blvd, Suite 500, San Jose, CA 95128-2560 | 2012-02-03 |
| Find all providers in SAN JOSE | ||||
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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.