MEDICARE: KIMBERLY A JOWER RD

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	133N00000X	Nutritionist
2	133NN1002X	Nutrition Education Nutritionist
3	133V00000X	Registered Dietitian	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	86291597	OTHER		ACADEMY OF NUTRITION AND DIETETICS

General Provider Information

NPI Number	:	1841056397
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY A JOWER RD

Provider Business Mailing Address
First Line	:	1217 PALOMA AVE APT 3
Second Line	:
City	:	BURLINGAME
State	:	CA
Zip	:	94010-3456
Country	:	US
Telephone Number	:	650-245-3252
Fax Number	:

Provider Business Practice Location Address
First Line	:	1217 PALOMA AVE APT 3
Second Line	:
City	:	BURLINGAME
State	:	CA
Zip	:	94010-3456
Country	:	US
Telephone Number	:	650-245-3252
Fax Number	:

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

Provider Enumeration Date	:	02/22/2024
Last Update Date	:	12/02/2025

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Directions to “ KIMBERLY A JOWER RD” Practice Location

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