North Bay Dermatology Assoc

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

NORTH BAY DERMATOLOGY ASSOC

Practice address

106 Lynch Creek Way
#8
Petaluma, CA 94954

Phone

(707) 763-6816

Fax

(707) 763-1730

NPI assigned

Nov 6, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Tina M Joerger

Title

Practice Manager

Phone

(207) 763-6816

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Cristina S Centurion, NP-C

  • Family Nurse Practitioner
  • Old Bridge, NJ
  • NPI 1710053095
  NPD (past)

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073682142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 LYNCH CREEK WAY",
            "address_2": "#8",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "94954",
            "telephone_number": "707-763-6816",
            "fax_number": "707-763-1730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 LYNCH CREEK WAY",
            "address_2": "#8",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "94954",
            "telephone_number": "707-763-6816",
            "fax_number": "707-763-1730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH BAY DERMATOLOGY ASSOC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JOERGER",
        "authorized_official_first_name": "TINA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "207-763-6816",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blake Thomas Nogleberg
• Nudrat Raza Noorani
• Norcal Healthconnect LLC
• Norcal Medical Supply, Inc
• North Bay Dermatology & Skin Cancer Center P C
• North Bay Dermatology Associates
• North Bay Electrology
• North Bay Endoscopy Center LLC
• North Bay Eye Associates, a Medical Corporation
• North Bay Foot & Ankle Center Inc

• Dermatology Physician in Petaluma, CA
• Providers in Petaluma, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.