Individual provider Active NPI

Kristin Bowen

  • Psychiatric/Mental Health Nurse Practitioner
  • Santa Rosa, CA
National Provider Identifier
1922823160
Registry record updated Mar 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95034149 Issued in CA
Practice address
1287 Fulton Rd
Santa Rosa, CA 95401-4923
Phone
(707) 800-7700
NPI assigned
Nov 21, 2024
Last updated
Mar 4, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95034149 CA Primary
Psychiatric/Mental Health Registered Nurse 163WP0808X 95048069 CA

Addresses

Primary practice location

1287 Fulton Rd
Santa Rosa, CA 95401-4923

Mailing address

PO Box 82
Corte Madera, CA 94976-0082
Phone (650) 257-0484

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250730001100 CA Practitioner - Nurse Practitioner 7517474919 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95048069CAMDPsychiatric/Mental Health Registered Nurse
95034149CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Torrico Medical Group Inc CurrentSince Jul 1, 2025 Accepting new patients

Locations

1287 Fulton Rd
Santa Rosa, CA 95401
Phone (707) 543-2031

2448 Guerneville Rd
Ste 800
Santa Rosa, CA 95403
Phone (707) 772-7522

200 S Main St
Ste 130
Sebastopol, CA 95472

Organizations & group practices 1

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": "1732147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741046400000",
    "number": "1922823160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 82",
            "city": "CORTE MADERA",
            "state": "CA",
            "postal_code": "949760082",
            "telephone_number": "650-257-0484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1287 FULTON RD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954014923",
            "telephone_number": "707-800-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWEN",
        "first_name": "KRISTIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-21",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95034149",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95048069",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.