Katherine Kielich, REGISTERED DIETITIAN

Individual provider Active NPI Registered Dietitian · Fairfax, CA

NPI 1043583719 · NPPES record last updated Feb 10, 2012

Key facts

NPI
1043583719
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
999771 (CA)
Practice address
51 Belle Ave
Fairfax, CA 94930-1725
Phone
(415) 847-4114
NPI assigned
Feb 10, 2012
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
999771CAMDRegistered Dietitian

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 999771 CA Yes

Addresses

Primary practice location

51 Belle Ave
Fairfax, CA 94930-1725

Mailing address

51 Belle Ave
Fairfax, CA 94930-1725
Phone (415) 847-4114

Other providers in Fairfax, CA

All providers in Fairfax, CA · Registered Dietitian in California

Sources for this page

Verify at the official NPI Registry.