Basic Information
| Provider Information | |||||||||
| NPI: | 1780121582 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GIKUHI | ||||||||
| FirstName: | JOTHAM | ||||||||
| MiddleName: | KAHORO | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 14761 | ||||||||
| Address2: | |||||||||
| City: | SANTA ROSA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 954026761 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7076233015 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 983 SONOMA AVE | ||||||||
| Address2: | |||||||||
| City: | SANTA ROSA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 954044818 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7075838700 | ||||||||
| FaxNumber: | 7073034066 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/31/2017 | ||||||||
| LastUpdateDate: | 11/02/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/02/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WC1500X | 86958 | CA | N | Nursing Service Providers | Registered Nurse | Community Health | 363L00000X | 95006950 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 163W00000X | 740595 | CA | N | Nursing Service Providers | Registered Nurse |
No ID Information.