Kimberly J Whelan, RD | |
2211 Moorpark Ave Ste 218, San Jose, CA 95128-2629 | |
(408) 998-2325 | |
Not Available |
Full Name | Kimberly J Whelan |
---|---|
Gender | Female |
Speciality | Dietitian, Registered |
Location | 2211 Moorpark Ave Ste 218, San Jose, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1356601017 | NPI | - | NPPES |
926569 | Other | CA | REGISTERED DIETITIAN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
133V00000X | Dietitian, Registered | 926569 (California) | Primary |
Provider Name | Nourish, Inc. |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1558097824 PECOS PAC ID: 1557724937 Enrollment ID: O20230901000471 |
Mailing Address | Practice Location Address |
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Kimberly J Whelan, RD Po Box 33093, Los Gatos, CA 95031 Ph: (831) 818-4462 | Kimberly J Whelan, RD 2211 Moorpark Ave Ste 218, San Jose, CA 95128-2629 Ph: (408) 998-2325 |
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