Healthcare Provider Details

I. General information

NPI: 1003745001
Provider Name (Legal Business Name): KRISTEN P CATON
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4225 WAYVERN DR
SANTA ROSA CA
95409-7108
US

IV. Provider business mailing address

1045 FRYER CREEK DR
SONOMA CA
95476-7573
US

V. Phone/Fax

Practice location:
  • Phone: 707-324-5596
  • Fax:
Mailing address:
  • Phone: 707-849-3777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XG0600X
TaxonomyGerontology Occupational Therapist
License Number2616
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: