Individual provider Active NPI

John W. Kolhoven

  • Counseling Psychologist
  • Santa Rosa, CA
National Provider Identifier
1194887299
Registry record updated Nov 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
20874 Issued in CA
Practice address
5755 Mountain Hawk Dr
Suite 205 a
Santa Rosa, CA 95409-4450
Phone
(707) 321-8650
NPI assigned
Dec 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 20874 CA Primary

Addresses

Primary practice location

5755 Mountain Hawk Dr
Suite 205 a
Santa Rosa, CA 95409-4450

Mailing address

5755 Mountain Hawk Dr
Suite 205a
Santa Rosa, CA 95409-4450
Phone (707) 321-8650

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384214400000",
    "number": "1194887299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5755 MOUNTAIN HAWK DR",
            "address_2": "SUITE 205A",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954094450",
            "telephone_number": "707-321-8650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5755 MOUNTAIN HAWK DR",
            "address_2": "SUITE 205 A",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954094450",
            "telephone_number": "707-321-8650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLHOVEN",
        "first_name": "JOHN",
        "middle_name": "W.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-14",
        "last_updated": "2013-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "CA",
            "license": "20874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.