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Contact Information

PENNY R VANDESTREEK, DO
1 MEDICAL PLAZA DR
ATT: NUCLEAR MEDICINE
ROSEVILLE, CA95661-3037
 Phone: 916-781-1292
 Fax: 916-663-9912
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nuclear Medicine

207U00000X 36 Physician/Nuclear Medicine
 

In Vivo & In Vitro Nuclear Medicine

207UN0903X 36 Physician/Nuclear Medicine
 

Nuclear Cardiology

207UN0901X 36 Physician/Nuclear Medicine
 

Nuclear Imaging & Therapy

207UN0902X 36 Physician/Nuclear Medicine
Indicates primary specialty

NPI Profile & details for PENNY R VANDESTREEK · (Female)

NPI # 1164463402
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 06/09/2006
Last updated 11/17/2023 - About 3 years ago
Sole proprietor 1 Yes
Identifiers
  • CA License # 20A6232
  • CA Medicaid 00AX62320
  • CA Other P00017739 RAILROAD MEDICARE
Hospital affiliation(s)
  • SUTTER AUBURN FAITH HOSPITAL - (Acute Care)
    11815 EDUCATION STREET
    AUBURN, CA 95603
  • SUTTER DAVIS HOSPITAL - (Acute Care)
    2000 SUTTER PLACE
    DAVIS, CA 95616
  • SUTTER GENERAL HOSPITAL - (Acute Care)
    2801 L STREET
    SACRAMENTO, CA 95816
  • SUTTER ROSEVILLE MEDICAL CENTER - (Acute Care)
    ONE MEDICAL PLAZA
    ROSEVILLE, CA 95661
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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