MEDICARE: JENNIFER KATHLEEN WHITE RDN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133NN1002X	Nutrition Education Nutritionist
2	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1093674723
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER KATHLEEN WHITE RDN

Provider Business Mailing Address
First Line	:	7800 WALSH LN
Second Line	:
City	:	SMARTSVILLE
State	:	CA
Zip	:	95977-9726
Country	:	US
Telephone Number	:	530-868-7838
Fax Number	:	530-868-7838

Provider Business Practice Location Address
First Line	:	1908 N BEALE RD
Second Line	:
City	:	MARYSVILLE
State	:	CA
Zip	:	95901-6937
Country	:	US
Telephone Number	:	530-777-8280
Fax Number	:	530-777-8280

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2026
Last Update Date	:	01/19/2026

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