Individual provider Active NPI

Kathleen L. Horan, M.D.

  • Family Medicine Physician
  • Santa Rosa, CA
National Provider Identifier
1558422717
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G35154 Issued in CA
Practice address
131 Stony Cir Ste 1600
Santa Rosa, CA 95401-9520
Phone
(707) 541-7700
Fax
(707) 573-5415
NPI assigned
Dec 12, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G35154 CA Primary

Addresses

Primary practice location

131 Stony Cir Ste 1600
Santa Rosa, CA 95401-9520

Mailing address

2350 W El Camino Real FL 2
Mountain View, CA 94040-6203
Phone (707) 541-7700

Other identifiers 1

IdentifierTypeStateIssuer
G35154OtherCASTATE MEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090629000301 CA Practitioner - Family Practice 3375694540 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35154CAMDOptometrist
G35154CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Bay Medical Foundation Family Medicine CurrentSince Aug 1, 2017 Accepting new patients
Sutter Bay Medical Foundation Current Accepting new patients
Sutter Bay Medical Foundation CurrentSince Aug 1, 2017 Accepting new patients

Locations

2350 W El Camino Real
Fl 2
Mountain View, CA 94040
Phone (650) 691-6174

131 Stony Cir
Ste 1600
Santa Rosa, CA 95401
Phone (707) 541-7700

3883 Airway Dr
Ste 220
Santa Rosa, CA 95403
Phone (707) 521-7750

4700 Hoen Ave
Santa Rosa, CA 95405
Phone (707) 526-3360

510 Doyle Park Dr
Santa Rosa, CA 95405
Phone (707) 303-8360

8465 Old Redwood Hwy
Ste 320
Windsor, CA 95492
Phone (707) 433-5494

Interoperability endpoints

  • Direct secure messaging: khoran32539@hisp.ehr.sutterhealth.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1558422717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 W EL CAMINO REAL FL 2",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940406203",
            "telephone_number": "707-541-7700",
            "fax_number": "707-573-5415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 STONY CIR STE 1600",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954019520",
            "telephone_number": "707-541-7700",
            "fax_number": "707-573-5415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORAN",
        "first_name": "KATHLEEN",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G35154",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "G35154",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.