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NORTH BAY DERMATOLOGY ASSOC
NPI 1073682142
Dermatology in Petaluma, CA

Active since November 06, 2006CLIA 05D0605021 · Certificate of Compliance
106 LYNCH CREEK WAY, #8, PETALUMA, CA 94954(707) 763-6816(707) 763-1730 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About North Bay Dermatology Assoc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NORTH BAY DERMATOLOGY ASSOC (NPI 1073682142) is a healthcare organization registered as a dermatology in Petaluma, California and active in the NPI registry since November 2006. The organization holds a CLIA Certificate of Compliance certificate valid through April 24, 2027 and lists Tina M Joerger, Practice Manager, as its authorized official.

NPPES Registry Identity

NPI1073682142
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameNORTH BAY DERMATOLOGY ASSOC
Location Address106 LYNCH CREEK WAY, #8Petaluma, CA 94954
Mailing Address106 Lynch Creek Way, #8Petaluma, CA 94954 · (707) 763-6816 · Fax (707) 763-1730
Phone(707) 763-6816
Fax(707) 763-1730
Organization SubpartNo
Authorized OfficialTina M JoergerPractice Manager · (207) 763-6816
Enumeration DateNovember 6, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1073682142 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
106 LYNCH CREEK WAY, Petaluma, CA 94954
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 05D0605021

North Bay Dermatology Associates · Petaluma, CA
Active · expires Apr 24, 2027
CLIA Number05D0605021
Laboratory TypePhysician Office
Certificate Effective DateApril 25, 2025
Certificate Expiration DateApril 24, 2027
Laboratory DirectorSantiago A. Centurion MD
Laboratory Phone(707) 763-6816
Laboratory LocationNorth Bay Dermatology Associates106 Lynch Creek Way, Ste 8, Petaluma, CA 94954
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ELPIDIO C MARIANO M.D.
Surgery
106 LYNCH CREEK WAY, SUITE 9B
PETALUMA, CA 94954
Sonoma County (707) 763-1575
NORTH BAY DERMATOLOGY ASSOCIATES
Specialist
106 LYNCH CREEK WAY, SUITE #8
PETALUMA, CA 94954
Sonoma County (707) 763-6816
NORTH BAY DERMATOLOGY & SKIN CANCER CENTER P C
Dermatology
106 LYNCH CREEK WAY, 8
PETALUMA, CA 94954
Sonoma County (707) 763-6816
PETALUMA VALLEY HEARING CENTER
Case Management
106 LYNCH CREEK WAY, SUITE 9A
PETALUMA, CA 94954
Sonoma County (866) 853-3499
DENNIS M. MCLEOD, M.D., INC
Otolaryngology
106 LYNCH CREEK WAY, SUITE 9A
PETALUMA, CA 94954
Sonoma County (707) 762-3561

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is North Bay Dermatology Assoc's NPI number?

The NPI number for North Bay Dermatology Assoc is 1073682142. It was assigned to this organization in the NPPES registry on November 6, 2006.

Where is North Bay Dermatology Assoc located?

North Bay Dermatology Assoc is located at 106 Lynch Creek Way #8, Petaluma, CA 94954. The listed phone number is (707) 763-6816.

What is North Bay Dermatology Assoc's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Does North Bay Dermatology Assoc hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 05D0605021) is associated with this NPI, valid through April 24, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for North Bay Dermatology Assoc was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.