Provider Demographics
NPI:1780121582
Name:GIKUHI, JOTHAM KAHORO (FNP)
Entity type:Individual
Prefix:
First Name:JOTHAM
Middle Name:KAHORO
Last Name:GIKUHI
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 14761
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95402-6761
Mailing Address - Country:US
Mailing Address - Phone:707-623-3015
Mailing Address - Fax:
Practice Address - Street 1:983 SONOMA AVE
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95404-4818
Practice Address - Country:US
Practice Address - Phone:707-583-8700
Practice Address - Fax:707-303-4066
Is Sole Proprietor?:No
Enumeration Date:2017-01-31
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86958163WC1500X
CA95006950363L00000X
CA740595163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163W00000XNursing Service ProvidersRegistered Nurse