Kaitlyn Elizabeth Fakouri, FNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95019130 Issued in CA

Practice address

3441 Marysville Blvd
Sacramento, CA 95838-4512

Phone

(916) 737-5555

NPI assigned

Nov 12, 2021

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

Electronic endpoints 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kfakouri769594@direct.ochin.org
• Direct secure messaging: kaitlyn.fakouri.p1@direct.wellspacehealth.nextgenshare.com

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

• Daiya Healthcare PLLC

  • Internal Medicine Physician
  • Bellevue, WA
  • NPI 1477027381

  CA

  Medicare reassignment NPD
• Wellspace Health

  • Federally Qualified Health Center (FQHC)
  • Sacramento, CA
  • NPI 1811455819
  NPD (past)

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

{
    "created_epoch": "1636675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773878400000",
    "number": "1821754979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 761",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "957410761",
            "telephone_number": "225-333-0806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3441 MARYSVILLE BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958384512",
            "telephone_number": "916-737-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAKOURI",
        "first_name": "KAITLYN",
        "middle_name": "ELIZABETH",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-12",
        "last_updated": "2026-03-19",
        "certification_date": "2026-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95019130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kfakouri@wellspacehealth.org",
            "affiliation": "N",
            "address_1": "3441 Marysville Blvd",
            "city": "Sacramento",
            "state": "CA",
            "country_code": "US",
            "postal_code": "958384512",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sammantha Fajardo, MA, BCBA
• Myra Magtibay Fajilan
• Arman Fakharian
• Fariborz David Fakhri, D.O.
• Hiba Fakhri, MD
• Troy M. Falck, MD
• Briah Kane Falco
• Daniel Augustine Falco, MD
• Christine L Falconer, LCSW
• Eric William Falconer

• Nurse Practitioner in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.