Kenneth Waters, RN, PHN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95040750 Issued in CA

Practice address

347 Andrieux St
Sonoma, CA 95476-6863

Phone

(707) 935-5100

NPI assigned

Oct 7, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1759795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786060800000",
    "number": "1457226714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1109 CLAYTON CT",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949452308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "347 ANDRIEUX ST",
            "city": "SONOMA",
            "state": "CA",
            "postal_code": "954766863",
            "telephone_number": "707-935-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERS",
        "first_name": "KENNETH",
        "credential": "RN, PHN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-10-07",
        "last_updated": "2026-08-07",
        "certification_date": "2026-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95281023",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95040750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher A Walter, D.O.
• Kristie Kesel Walthard, M.A.
• Amanda Rose Wanag, ASW
• Phuntsok Wangyal
• Susan Eleanor Warnock-Brooks, MFT AND LEP
• Noah D Weiss, MD
• Deborah West
• William Raaka, M.D. Inc.
• Mark Gorton Wills, MD
• Wirick Chiropractic Care

• Family Nurse Practitioner in Sonoma, CA
• Providers in Sonoma, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2026; 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.