Healthcare Provider Details

I. General information

NPI: 1912860545
Provider Name (Legal Business Name): KATE MATHIAS RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/29/2025
Certification Date: 12/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 PASTEUR DR
PALO ALTO CA
94304-2203
US

IV. Provider business mailing address

300 PASTEUR DR
PALO ALTO CA
94304-2203
US

V. Phone/Fax

Practice location:
  • Phone: 650-724-4617
  • Fax:
Mailing address:
  • Phone: 650-512-4497
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: