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Individual

KIMBERLY J WHELAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RD

Contact information

Practice address
2211 MOORPARK AVE STE 218, SAN JOSE, CA 95128-2629
(408) 998-2325
Mailing address
PO BOX 33093, LOS GATOS, CA 95031
(831) 818-4462

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
926569
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
926569
REGISTERED DIETITIAN
CA
Enumeration date
05/29/2012
Last updated
05/29/2012
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