Healthcare Provider Details

I. General information

NPI: 1922068048
Provider Name (Legal Business Name): KATHRYN MAE FARRAR RNFA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2006
Last Update Date: 07/13/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 PETALUMA AVE
SEBASTOPOL CA
95472-4215
US

IV. Provider business mailing address

100 DARTMOUTH WAY
WINDSOR CA
95492-9700
US

V. Phone/Fax

Practice location:
  • Phone: 707-829-4350
  • Fax:
Mailing address:
  • Phone: 707-217-2927
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN211785
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: