Healthcare Provider Details

I. General information

NPI: 1568387371
Provider Name (Legal Business Name): VARVARA GOWEN NUTRITION FOR YOU
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2377 GOLD MEADOW WAY STE 100
GOLD RIVER CA
95670-4444
US

IV. Provider business mailing address

2377 GOLD MEADOW WAY STE 100
GOLD RIVER CA
95670-4444
US

V. Phone/Fax

Practice location:
  • Phone: 916-965-4012
  • Fax: 916-965-1082
Mailing address:
  • Phone: 916-965-4012
  • Fax: 916-965-1082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: VARVARA GOWEN
Title or Position: OWNER
Credential: RD
Phone: 916-965-4012