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PACIFIC SKIN INSTITUTE
NPI 1184027104
Dermatology - Procedural Dermatology in Sacramento, CA

Active since October 05, 2014CLIA Certified · 6 labs
1495 RIVER PARK DR, SUITE 200, SACRAMENTO, CA 95815(916) 925-7020(916) 925-3680 Get Directions Write a Review

NPPES record last updated: July 9, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 9, 2021, Jul 1, 2021, Jan 8, 2020 and 1 more (4 updates tracked since 2018).

About Pacific Skin Institute NPPES

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

PACIFIC SKIN INSTITUTE (NPI 1184027104) is a healthcare organization registered as a procedural dermatology in Sacramento, California and active in the NPI registry since October 2014. The organization holds 6 active CLIA laboratory certificates, maintains 3 additional practice locations, and lists An Yen, Partner, as its authorized official.

NPPES Registry Identity

NPI1184027104
Entity TypeOrganization
Primary Taxonomy207NS0135X
Legal Business NamePACIFIC SKIN INSTITUTE
Location Address1495 RIVER PARK DR, SUITE 200Sacramento, CA 95815-4500
Mailing Address1495 River Park Dr, Suite 200Sacramento, CA 95815-4500 · (916) 925-7020 · Fax (916) 925-3680
Phone(916) 925-7020
Fax(916) 925-3680
Organization SubpartNo
Authorized OfficialAn YenPartner · (916) 925-6950
Enumeration DateOctober 5, 2014
Last NPPES UpdateJuly 9, 20214 updates tracked since enumeration
NPPES CertifiedJuly 9, 2021
✔ NPI 1184027104 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatology · Procedural DermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207NS0135X
License✔ Licensed in CA · A056462
Definition
Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers).
1495 RIVER PARK DR, Sacramento, CA 95815
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Secondary Practice Locations 3

Location 11010 Nut Tree Rd Ste 150-170Vacaville, CA 95687-4172 · Phone (916) 925-7020 · Fax (916) 925-3680
Location 2550 Plaza Dr Ste 120Folsom, CA 95630-4779 · Phone (916) 925-7020 · Fax (916) 925-3680
Location 39291 Laguna Springs Dr Ste 120Elk Grove, CA 95758-7844 · Phone (916) 925-7020 · Fax (916) 925-3680

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 6

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 05D0984472

Pacific Skin Institute · Sacramento, CA
Active · expires Jun 18, 2027
CLIA Number05D0984472
Laboratory TypePhysician Office
Certificate Effective DateJune 19, 2025
Certificate Expiration DateJune 18, 2027
Laboratory DirectorDr. An Yen
Laboratory Phone(916) 925-6950
Laboratory LocationPacific Skin Institute1495 River Park Dr Ste 200, Sacramento, CA 95815
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.

Certificate of Waiver 05D2317827

Pacific Skin Institute · Vacaville, CA
Active · expires Jan 30, 2027
CLIA Number05D2317827
Laboratory TypePhysician Office
Certificate Effective DateJanuary 31, 2025
Certificate Expiration DateJanuary 30, 2027
Laboratory DirectorRaja K. Sivamani
Laboratory Phone(916) 925-6950
Laboratory LocationPacific Skin Institute1010 Nut Tree Rd Ste 150, Vacaville, CA 95687
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 05D2328174

Pacific Skin Institute · Elk Grove, CA
Active · expires Aug 4, 2027
CLIA Number05D2328174
Laboratory TypePhysician Office
Certificate Effective DateAugust 5, 2025
Certificate Expiration DateAugust 4, 2027
Laboratory DirectorCynthia Chambers
Laboratory Phone(916) 925-6950
Laboratory LocationPacific Skin Institute9250 Big Horn Blvd Ste 100, Elk Grove, CA 95758
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 05D2317824

Pacific Skin Institute · Folsom, CA
Active · expires Jan 30, 2027
CLIA Number05D2317824
Laboratory TypePhysician Office
Certificate Effective DateJanuary 31, 2025
Certificate Expiration DateJanuary 30, 2027
Laboratory DirectorRaja K. Sivamani
Laboratory Phone(916) 925-7020
Laboratory LocationPacific Skin Institute1710 Prairie City Rd Ste 100, Folsom, CA 95630
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 05D2317826

Pacific Skin Institute · Rocklin, CA
Active · expires Jan 30, 2027
CLIA Number05D2317826
Laboratory TypePhysician Office
Certificate Effective DateJanuary 31, 2025
Certificate Expiration DateJanuary 30, 2027
Laboratory DirectorRaja K. Sivamani
Laboratory Phone(916) 925-6950
Laboratory LocationPacific Skin Institute6544 Lonetree Blvd, Rocklin, CA 95765
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 05D2315929

Pacific Skin Institute · Sacramento, CA
Active · expires Dec 19, 2026
CLIA Number05D2315929
Laboratory TypePhysician Office
Certificate Effective DateDecember 20, 2024
Certificate Expiration DateDecember 19, 2026
Laboratory DirectorRaja K. Sivamani
Laboratory Phone(916) 925-7020
Laboratory LocationPacific Skin Institute1491 River Park Dr Ste 101, Sacramento, CA 95815
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

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

GABRIELLA NICOLE SALISBURY FNP-C
Nurse Practitioner
1495 RIVER PARK DR
SACRAMENTO, CA 95815
Sacramento County (916) 925-7020
AN YEN M.D.
Dermatology (Procedural Dermatology)
1495 RIVER PARK DR, SUITE 200
SACRAMENTO, CA 95815
Sacramento County (916) 925-7020

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 Pacific Skin Institute's NPI number?

The NPI number for Pacific Skin Institute is 1184027104. It was assigned to this organization in the NPPES registry on October 5, 2014.

Where is Pacific Skin Institute located?

Pacific Skin Institute is located at 1495 River Park Dr Suite 200, Sacramento, CA 95815. The listed phone number is (916) 925-7020.

What is Pacific Skin Institute's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in Procedural Dermatology, with taxonomy code 207NS0135X.

Does Pacific Skin Institute hold CLIA laboratory certificates?

Yes. 6 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Pacific Skin Institute was last updated on July 9, 2021. 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.