Organization Active NPI

Solano Dermatology Associates Inc

  • Dermatology Physician
  • Vacaville, CA
National Provider Identifier
1356561682
Registry record updated Apr 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
019731 Issued in CA
Legal business name
SOLANO DERMATOLOGY ASSOCIATES INC
Practice address
600 Nut Tree Rd
Suite 260
Vacaville, CA 95687-4669
Phone
(707) 452-7222
Fax
(707) 452-8507
NPI assigned
Apr 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2012

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

Authorized official

Name
Ms. Sandie Fowler
Title
Credentialing Specialist
Phone
(707) 556-5991

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X 019731 CA Primary

Addresses

Primary practice location

600 Nut Tree Rd
Suite 260
Vacaville, CA 95687-4669

Mailing address

2290 Sacramento St
Vallejo, CA 94590-2929
Phone (707) 643-5785

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060928000473 CA Part B Supplier - Clinic/Group Practice 6305840422 Receives reassigned benefits from 15 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Vallejo, CA; Fairfield, CA; Vacaville, CA; Saint Helena, CA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D1078752Solano Dermatology Associates600 Nut Tree Rd, Ste 260, Vacaville, CA 95687ComplianceAug 25, 2026

National Provider Directory

National Provider Directory

Locations

807 Saint Helena Hwy S
Saint Helena, CA 94574
Phone (707) 963-5450

10 Woodland Rd
#501
Saint Helena, CA 94574
Phone (707) 963-5450

600 Nut Tree Rd
Ste 360
Vacaville, CA 95687
Phone (707) 452-7222

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1177632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334188800000",
    "number": "1356561682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2290 SACRAMENTO ST",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945902929",
            "telephone_number": "707-643-5785",
            "fax_number": "707-643-5876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 NUT TREE RD",
            "address_2": "SUITE 260",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956874669",
            "telephone_number": "707-452-7222",
            "fax_number": "707-452-8507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOLANO DERMATOLOGY ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-27",
        "last_updated": "2012-04-12",
        "status": "A",
        "authorized_official_last_name": "FOWLER",
        "authorized_official_first_name": "SANDIE",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "707-556-5991",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "CA",
            "license": "019731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vacaville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.