Kaitlyn Nicole Coughran

Primary specialty

Rehabilitation PractitionerTaxonomy code 225400000X

Practice address

2235 Mercury Way Ste 107
Santa Rosa, CA 95407-5472

Phone

(707) 571-5581

NPI assigned

Sep 1, 2025

Last updated

Nov 8, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1756684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762560000000",
    "number": "1679452858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2235 MERCURY WAY STE 107",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954075472",
            "telephone_number": "925-667-5878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2235 MERCURY WAY STE 107",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954075472",
            "telephone_number": "707-571-5581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COUGHRAN",
        "first_name": "KAITLYN",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-01",
        "last_updated": "2025-11-08",
        "certification_date": "2025-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Rehabilitation Practitioner in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Rehabilitation Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2025; 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.