Individual provider Active NPI

Kristen Kowalske, R.D.

  • Registered Dietitian
  • Sacramento, CA
National Provider Identifier
1053787671
Registry record updated Aug 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
978257 Issued in MI
Practice address
8001 Bruceville Rd
Sacramento, CA 95823-2329
Phone
(916) 288-0401
NPI assigned
Aug 18, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 978257 MI Primary

Addresses

Primary practice location

8001 Bruceville Rd
Sacramento, CA 95823-2329

Mailing address

1724 Guildford Way
Plumas Lake, CA 95961-9146

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
978257MIMDRegistered Dietitian

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1439856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439856000000",
    "number": "1053787671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1724 GUILDFORD WAY",
            "city": "PLUMAS LAKE",
            "state": "CA",
            "postal_code": "959619146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8001 BRUCEVILLE RD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958232329",
            "telephone_number": "916-288-0401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOWALSKE",
        "first_name": "KRISTEN",
        "name_prefix": "Ms.",
        "credential": "R.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-18",
        "last_updated": "2015-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MI",
            "license": "978257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.