Ligaya Park, DO

Public-record details

Address

2725 Mendocino Ave, Santa Rosa, CA 95403

Phone

(707) 545-4537

Listed under

Individual clinicians

NPI

1083849012

NPI status

Active in the NPPES registry

Provider type

Individual provider

Registered specialty (self-reported taxonomy)

Dermatology (207N00000X)

Credentials listed

DO

License number on NPI record

20A12072 (CA)

NPI first issued

May 20, 2009

Years since NPI first issued

17 years (since 2009)

License state on NPI record

CA

NPI record last updated

Mar 28, 2022

Medicare enrollment (CMS)

Enrolled: listed in CMS Doctors & Clinicians

Medicare assignment (CMS)

Accepts the Medicare-approved amount as payment in full

Professional school graduation (CMS)

2008 (18 years ago)

Professional school (CMS)

Western University of Health Sciences College of Dental Med

Medicare group practice (CMS)

Redwood Fam Dermatology Medical Associates - a Medical Corporation (17 clinicians)

Practice locations on file with Medicare (CMS)

1

Other dermatology listings at this street address

6

NPI 1083849012 is active in the federal NPPES registry (CMS) with Dermatology as its self-reported primary taxonomy; license 20A12072 (CA) is listed on the record. CMS Doctors & Clinicians lists this clinician as enrolled in Medicare. Source: NPPES NPI Registry (CMS) (record). Data as of 2026-10-16.

Public record, not an endorsement. This listing was compiled from public records as of 2026-10-16 and may be incomplete or out of date. Dermatologist Index does not vet, employ, recommend or guarantee dermatology practices; a badge reflects only what the public record showed on that date. Confirm current details with the official record before you decide. The information on Dermatologist Index is not medical advice and does not replace a doctor, nurse, discharge planner or other qualified professional. Do not use it to make decisions about diagnosis or treatment. If you have a medical emergency, call 911. Full disclaimer · Report an error

What these registry facts mean

The NPI (National Provider Identifier) is the federal ID every HIPAA-covered provider uses to bill insurance. This NPI belongs to an individual clinician. The specialty is the taxonomy the provider chose when registering; NPPES does not check it. A license number here is what the provider entered — confirm it with the state board before you rely on it. A registered specialty is not board certification. To check board certification, use the American Board of Dermatology's verification tool (or the American Osteopathic Board of Dermatology for DOs), and confirm the medical license with the state board.

View NPI 1083849012 in the official registry ↗

Practices and clinicians at this address

Other listings in this directory whose NPI record gives the same street address and ZIP. A shared address usually means a shared practice or building; it does not by itself show who works with whom.

• Jeffrey Sugarman, MD, PhD
• Judith Groves, MD
• Brianne Dickey
• Albert Peng, MD
• Redwood Fam Dermatology Medical Associates - a Medical Corporation (practice/organization)
• Northern California Medical Assoc INC (practice/organization)