Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Novato Dermatology Associates a Medical Corporation

Organization Dermatology Physician · NPI 1003960063

Novato Dermatology Associates a Medical Corporation is a Dermatology Physician in Novato, California. Licensed in California. Registered with an NPI since 2007.

Licensed in
CA
In the registry since
2007

Practice location Address checks out

867 Diablo Ave
Novato, CA 94947-4007
Phone: (415) 892-0754
Fax: (415) 897-3204
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence G79619 (CA)

Record details

NPI number1003960063
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kim Frederickson — Owner · (415) 892-0754
NPI enumeratedJanuary 23, 2007
Last updated in NPPESNovember 8, 2018
Mailing address867 Diablo Ave, Novato, CA 94947-4007

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