Healthcare Provider Details
I. General information
NPI: 1265415830
Provider Name (Legal Business Name): ROSALIE JANE HAGGE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X
II. Dates (important events)
Enumeration Date: 11/28/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4860 Y ST SUITE 3100
SACRAMENTO CA
95817-2307
US
IV. Provider business mailing address
4860 Y ST SUITE 3100
SACRAMENTO CA
95817-2307
US
V. Phone/Fax
- Phone: 916-703-2273
- Fax: 916-703-2274
- Phone: 916-703-2273
- Fax: 916-703-2274
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207U00000X |
| Taxonomy | Nuclear Medicine Physician |
| License Number | G86720 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207U00000X |
| Taxonomy | Nuclear Medicine Physician |
| License Number | 98-00887 |
| License Number State | NC |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207U00000X |
| Taxonomy | Nuclear Medicine Physician |
| License Number | L3672 |
| License Number State | TX |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207U00000X |
| Taxonomy | Nuclear Medicine Physician |
| License Number | MED101722 |
| License Number State | MO |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | G86720 |
| License Number State | CA |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | 98-00887 |
| License Number State | NC |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | L3672 |
| License Number State | TX |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | MED101722 |
| License Number State | MO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: