Northern California P.E.T. Imaging Center

Primary specialty

Nuclear Medicine PhysicianTaxonomy code 207U00000X

Legal business name

NORTHERN CALIFORNIA P.E.T. IMAGING CENTER

Practice address

3718 Atherton Rd
Rocklin, CA 95765-3717

Phone

(916) 737-3211

Fax

(916) 737-6203

NPI assigned

Apr 27, 2023

Last updated

Mar 27, 2025By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jeanette Haley

Title

Administrative Director

Phone

(916) 737-3214

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Northern California P.E.T. Imaging Center

  • Nuclear Medicine Physician
  • Roseville, CA
  • NPI 1790734317

  9830156926

  Same PAC ID
• Northern California P.E.T. Imaging Center

  • Radiology Clinic/Center
  • Sacramento, CA
  • NPI 1992754741

  9830156926

  Same PAC ID

Tax ID family

No Calif Pet Imaging3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Northern California P.E.T. Imaging Center

  • Nuclear Medicine Physician
  • Roseville, CA
  • NPI 1790734317
  NPD tax ID
• Northern California P.E.T. Imaging Center

  • Radiology Clinic/Center
  • Sacramento, CA
  • NPI 1992754741
  NPD tax ID

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Samuel L Kipper, M.D.

  • Nuclear Radiology Physician
  • Santa Ana, CA
  • NPI 1265498836
  NPD
• Dafang Wu, MD

  • Nuclear Medicine Physician
  • Sacramento, CA
  • NPI 1871553834
  NPD
• Yamin Dou, M.D.

  • Nuclear Imaging & Therapy Physician
  • Burlington, MA
  • NPI 1568411320
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1682553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743033600000",
    "number": "1659069672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3195 FOLSOM BLVD STE 110",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165264",
            "telephone_number": "916-737-3211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3718 ATHERTON RD",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "957653717",
            "telephone_number": "916-737-3211",
            "fax_number": "916-737-6203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN CALIFORNIA P.E.T. IMAGING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-27",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A",
        "authorized_official_last_name": "HALEY",
        "authorized_official_first_name": "JEANETTE",
        "authorized_official_title_or_position": "ADMINISTRATIVE DIRECTOR",
        "authorized_official_telephone_number": "916-737-3214"
    },
    "taxonomies": [
        {
            "code": "207U00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nuclear Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0088760",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emi Nogen
• Destiny Nicole Nolan
• Norcal Mobile Wound Care a Physician Assistant Corporation
• Norcal Treatment Centers
• Cloie Norman
• Jeanette Nuno, CMT
• Taylah Nusser
• Patrick Nwaukoni
• Jared Nyagol
• Abigail Raye Nye

• Nuclear Medicine Physician in Rocklin, CA
• Providers in Rocklin, CA by specialty
• Nuclear Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.