Active NPI
Jennifer Michelle Bange, RDN
- Registered Dietitian
- Hollister, CA
National Provider Identifier
1134098817
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 724291
- Practice address
- 2111 Raleigh Cir
Hollister, CA 95023-5233 - Phone
- (831) 801-3872
- NPI assigned
- Nov 1, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 724291 | CA | Primary |
Addresses
Primary practice location
2111 Raleigh Cir
Hollister, CA 95023-5233
Mailing address
2111 Raleigh Cir
Hollister, CA 95023-5233
Phone (831) 801-3872
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
| License | State | Type | Specialty |
|---|---|---|---|
| 724291 | CA | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1761955200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1761955200000",
"number": "1134098817",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2111 RALEIGH CIR",
"city": "HOLLISTER",
"state": "CA",
"postal_code": "950235233",
"telephone_number": "831-801-3872"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2111 RALEIGH CIR",
"city": "HOLLISTER",
"state": "CA",
"postal_code": "950235233",
"telephone_number": "831-801-3872"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANGE",
"first_name": "JENNIFER",
"middle_name": "MICHELLE",
"credential": "RDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-11-01",
"last_updated": "2025-11-01",
"certification_date": "2025-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dietitian, Registered",
"state": "CA",
"license": "724291",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hollister, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.