NPIMap

Organization Active NPI

Regents of the Univ of Ca

  • Dermatology Physician
  • Sacramento, CA
National Provider Identifier
1184617102
Registry record updated May 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
REGENTS OF THE UNIV OF CA
Practice address
3301 C St
Sacramento, CA 95816-3300
Phone
(916) 734-6111
Fax
(916) 451-7245
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
Dermatology Physician 207N00000X Primary

Addresses

Primary practice location

3301 C St
Sacramento, CA 95816-3300

Mailing address

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

Other identifiers 8

IdentifierTypeStateIssuer
CR0028OtherCARAILROAD MEDICARE PIN
CN4844OtherCARAILROAD MEDICARE PIN
DE7275OtherCARAILROAD MEDICARE PIN
DA4168OtherCARAILROAD MEDICARE PIN
CI4127OtherCARAILROAD MEDICARE PIN
GNP000070MedicaidCA
GR0021043MedicaidCA
CN4400OtherCARAILROAD MEDICARE PIN

Other names 1

  • Regents UCDPBG Dermatolo 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

Locations

2440 W Covell Blvd
Ste 104
Davis, CA 95616
Phone (530) 747-3000

77 Cadillac Dr
Ste 240
Sacramento, CA 95825
Phone (916) 569-4400

Practitioners & affiliated clinicians

Practitioners 29

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 29

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": "1184617102",
    "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": "916-734-9661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 C ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958163300",
            "telephone_number": "916-734-6111",
            "fax_number": "916-451-7245"
        }
    ],
    "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": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN",
            "identifier": "CR0028",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN",
            "identifier": "CN4844",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN",
            "identifier": "DE7275",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN",
            "identifier": "DA4168",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN",
            "identifier": "CI4127",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GNP000070",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0021043",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN",
            "identifier": "CN4400",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Regents UCDPBG Dermatolo",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Regents UCDPBG Dermatolo",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Sacramento, 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.