Individual provider · NPI-1

Dr. Penny Robillard Vandestreek, D.O.

Nuclear Medicine · Roseville, CA

NPI number1164463402
StatusActive
Last updated in NPPESNov 17, 2023

Details

NPI
1164463402
Entity type
Individual (NPI-1)
Name
Dr. Penny Robillard Vandestreek
Credential
D.O.
Sex
Female
Sole proprietor
Yes
Enumeration date
Jun 9, 2006
Certification date
Nov 17, 2023
Last updated
Nov 17, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207U00000X Nuclear Medicine20A6232CAYes
207UN0903X Nuclear Medicine, In Vivo & In Vitro Nuclear Medicine20A6232CA
207UN0902X Nuclear Medicine, Nuclear Imaging & Therapy20A6232CA
207UN0901X Nuclear Medicine, Nuclear Cardiology20A6232CA

Practice location

1 Medical Plaza Dr
Att: Nuclear Medicine
Roseville, CA 95661-3037

Phone 916-781-1292 · Fax 916-663-9912

Mailing address

10470 Old Placerville Rd
#100
Sacramento, CA 95827-2539

Phone 800-470-0071

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