Healthcare Provider Details

I. General information

NPI: 1659164655
Provider Name (Legal Business Name): CHRISTOPHER DANIEL KUTCHES FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2025
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1162 MONTGOMERY DR FL 2
SANTA ROSA CA
95405-4802
US

IV. Provider business mailing address

1162 MONTGOMERY DR FL 2
SANTA ROSA CA
95405-4802
US

V. Phone/Fax

Practice location:
  • Phone: 707-890-4100
  • Fax:
Mailing address:
  • Phone: 707-217-3882
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95035838
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WH1000X
TaxonomyHospice Registered Nurse
License Number764558
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: