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GOLDEN STATE DERMATOLOGY ASSOCIATES, INC.
NPI 1235738576
Clinic/Center - Ambulatory Surgical in Fresno, CA

Active since October 19, 2020CLIA Certified · 2 labs
6769 N FRESNO ST, FRESNO, CA 93710(559) 435-0337 Get Directions Write a Review

NPPES record last updated: October 19, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Golden State Dermatology Associates, Inc. NPPES

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

GOLDEN STATE DERMATOLOGY ASSOCIATES, INC. (NPI 1235738576) is a healthcare organization registered as an ambulatory surgical in Fresno, California and active in the NPI registry since October 2020. The organization holds 2 active CLIA laboratory certificates and lists Jeffrey Thomas Bortz, Authorized Official, as its authorized official.

NPPES Registry Identity

NPI1235738576
Entity TypeOrganization
Primary Taxonomy261QA1903X
Legal Business NameGOLDEN STATE DERMATOLOGY ASSOCIATES, INC.
Location Address6769 N FRESNO STFresno, CA 93710-3715
Mailing Address355 Lennon Ln Ste 255Walnut Creek, CA 94598-2496 · (925) 932-7704
Phone(559) 435-0337
Organization SubpartNo
Authorized OfficialJeffrey Thomas BortzAuthorized Official · (925) 932-7704
Enumeration DateOctober 19, 2020
NPPES CertifiedOctober 19, 2020
✔ NPI 1235738576 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities
Taxonomy Code261QA1903X
6769 N FRESNO ST, Fresno, CA 93710
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CLIA Laboratory Certificates CMS CLIA 4

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 for Provider-Performed Microscopy Procedures (PPMP) 05D2342602

Golden State Dermatology Associates, Inc · Walnut Creek, CA
Active · expires Apr 21, 2028
CLIA Number05D2342602
Laboratory TypePhysician Office
Certificate Effective DateApril 22, 2026
Certificate Expiration DateApril 21, 2028
Laboratory DirectorJeffrey Bortz
Laboratory Phone(925) 357-9786
Laboratory LocationGolden State Dermatology Associates, Inc355 Lennon Lane Ste 295, Walnut Creek, CA 94598
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate of Accreditation 05D2167095

Golden State Dermatology Associates, Inc · Walnut Creek, CA
Active · expires Sep 5, 2027
CLIA Number05D2167095
Laboratory TypeIndependent
Certificate Effective DateSeptember 6, 2025
Certificate Expiration DateSeptember 5, 2027
Laboratory DirectorDr. Emily A. Green
Laboratory Phone(925) 278-7592
Laboratory LocationGolden State Dermatology Associates, Inc370 N Wiget Ln, Ste 250, Walnut Creek, CA 94598
CLIA data matches this NPI record on: Name
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Certificate of Compliance 05D0906539

Golden State Dermatology Associates · Walnut Creek, CA
Expired · Jul 31, 2026
CLIA Number05D0906539
Laboratory TypePhysician Office
Certificate Effective DateApril 8, 2024
Certificate Expiration DateJuly 31, 2026
Laboratory DirectorJeffrey T. Bortz
Laboratory Phone(925) 932-7704
Laboratory LocationGolden State Dermatology Associates355 Lennon Ln Ste 255, Walnut Creek, CA 94598
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 Compliance 05D0912897

Golden State Dermatology · Fresno, CA
Expired · Jul 31, 2026
CLIA Number05D0912897
Laboratory TypePhysician Office
Certificate Effective DateJune 26, 2024
Certificate Expiration DateJuly 31, 2026
Laboratory DirectorJane F. Kardashian
Laboratory Phone(559) 435-0337
Laboratory LocationGolden State Dermatology6769 N Fresno St, Ste 101, Fresno, CA 93710
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 7

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

ALI REZAPOUR, M.D., INC.
Specialist
6769 N FRESNO ST, SUITE # 204
FRESNO, CA 93710
Fresno County (559) 353-9353
ADVANCED DERMATOLOGY SURGERY CENTER, INC
Clinic/Center (Ambulatory Surgical)
6769 N FRESNO ST
FRESNO, CA 93710
Fresno County (559) 435-0337
JANE F. KARDASHIAN, M.D., INC.
Clinic/Center (Ambulatory Surgical)
6769 N FRESNO ST
FRESNO, CA 93710
Fresno County (559) 435-0337
DR. JANE F. KARDASHIAN M.D.
Dermatology
6769 N FRESNO ST
FRESNO, CA 93710
Fresno County (559) 435-0337
DR. CHARLES ROY PHILLIPS MD
Emergency Medicine
6769 N FRESNO ST, #210
FRESNO, CA 93710
Fresno County (559) 440-1500
MRS. JANET MELIKYAN FNP-C
Nurse Practitioner (Family)
6769 N FRESNO ST
FRESNO, CA 93710
Fresno County (559) 435-0337
MRS. FRANCISCA EZEGALU OLALEMI N.P
Nurse Practitioner (Family)
6769 N FRESNO ST, SUITE #201
FRESNO, CA 93710
Fresno County (559) 440-1500

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 Golden State Dermatology Associates, Inc.'s NPI number?

The NPI number for Golden State Dermatology Associates, Inc. is 1235738576. It was assigned to this organization in the NPPES registry on October 19, 2020.

Where is Golden State Dermatology Associates, Inc. located?

Golden State Dermatology Associates, Inc. is located at 6769 N Fresno St, Fresno, CA 93710. The listed phone number is (559) 435-0337.

What is Golden State Dermatology Associates, Inc.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.

Does Golden State Dermatology Associates, Inc. hold CLIA laboratory certificates?

Yes. 2 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 Golden State Dermatology Associates, Inc. was last updated on October 19, 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.