MEDICARE: KRISTIN D ROSE 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	133V00000X	Registered Dietitian	86359085	CA
2	133VN1101X	Gerontological Nutrition Registered Dietitian	86359085	CA

General Provider Information

NPI Number	:	1598648396
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTIN D ROSE RDN

Provider Business Mailing Address
First Line	:	2142 JERROLD AVE
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94124-1010
Country	:	US
Telephone Number	:	415-343-1282
Fax Number	:

Provider Business Practice Location Address
First Line	:	542 UTAH ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94110-1437
Country	:	US
Telephone Number	:	650-580-9381
Fax Number	:

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

Provider Enumeration Date	:	07/29/2025
Last Update Date	:	07/29/2025

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Directions to “ KRISTIN D ROSE RDN” Practice Location

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