Individual provider Active NPI

Anna Jayoung Kwon

  • Registered Dietitian
  • Fresno, CA
National Provider Identifier
1427908854
Registry record updated Feb 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Practice address
1222 W Shaw Ave
Fresno, CA 93711-3706
Phone
(805) 290-2339
NPI assigned
Feb 3, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2026

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 Primary

Addresses

Primary practice location

1222 W Shaw Ave
Fresno, CA 93711-3706

Mailing address

13336 Vinewood
Moorpark, CA 93021-3018

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260219002866 CA Practitioner - Registered Dietitian Or Nutrition Professional 9931680733 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

8737 Fletcher Pkwy
Apt 666
La Mesa, CA 91942-3234

8737 Fletcher Pkwy Apt
Suite 666
LA Mesa, CA 91942-3239

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fueled by Leo, Inc. Dietitian, Registered CurrentSince Feb 3, 2026 Accepting new patients

Locations

5100 N 6th St
Ste 135
Fresno, CA 93710
Phone (559) 490-2067

1222 W Shaw Ave
Fresno, CA 93711
Phone (559) 512-0404

Organizations & group practices 1

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": "1770076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770076800000",
    "number": "1427908854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13336 VINEWOOD",
            "city": "MOORPARK",
            "state": "CA",
            "postal_code": "930213018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 W SHAW AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937113706",
            "telephone_number": "805-290-2339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWON",
        "first_name": "ANNA",
        "middle_name": "JAYOUNG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-02-03",
        "last_updated": "2026-02-03",
        "certification_date": "2026-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.