Organization Active NPI

Regents of the Univ of Ca

  • Medical Microbiology Physician
  • Davis, CA
National Provider Identifier
1053304071
Registry record updated May 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Microbiology PhysicianTaxonomy code 207ZM0300X
Legal business name
REGENTS OF THE UNIV OF CA
Practice address
3146 Tupper Hall
Davis, CA 95616
Phone
(530) 752-9402
NPI assigned
Aug 24, 2005
Last updated
May 16, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2025

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

Authorized official

Name
Tammy Trovatten
Title
Vice President, Gov'T Reimbursement
Phone
(916) 855-2315

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Microbiology Physician 207ZM0300X NU Primary

Addresses

Primary practice location

3146 Tupper Hall
Davis, CA 95616

Mailing address

10850 White Rock Rd
Rancho Cordova, CA 95670-6044
Phone (916) 734-9200

Other identifiers 1

IdentifierTypeStateIssuer
GR002104CMedicaidCA

Other names 1

  • Regents UCDPBG Microbio Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031111000892 CA Part B Supplier - Clinic/Group Practice 3375456619 Receives reassigned benefits from 2,647 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747353600000",
    "number": "1053304071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10850 WHITE ROCK RD",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956706044",
            "telephone_number": "916-734-9200",
            "fax_number": "916-734-9336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3146 TUPPER HALL",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "95616",
            "telephone_number": "530-752-9402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENTS OF THE UNIV OF CA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-24",
        "last_updated": "2025-05-16",
        "certification_date": "2025-05-16",
        "status": "A",
        "authorized_official_last_name": "TROVATTEN",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_title_or_position": "VICE PRESIDENT, GOV'T REIMBURSEMENT",
        "authorized_official_telephone_number": "916-855-2315"
    },
    "taxonomies": [
        {
            "code": "207ZM0300X",
            "taxonomy_group": "",
            "desc": "Pathology, Medical Microbiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR002104C",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Regents UCDPBG Microbio",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Regents UCDPBG Microbio",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Davis, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 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.