Kathy Bourque, RD
NPI 1629457171ActiveIndividual· Dietitian, Registered· Fremont, CA
Dietitian, Registered (RD) in Fremont, California, licensed in CA, with an NPI issued in May 2015. Enrolled in Medicare as practitioner - registered dietitian or nutrition professional.
Overview
| NPI | 1629457171 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | RD |
| Sole proprietor | No |
| NPI issued | May 29, 2015 |
| Last updated in NPPES | May 29, 2015 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dietitian, Registered Primary | 133V00000X | 1066457 | CA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Registered Dietitian Or Nutrition Professional (CA) |
|---|
Education and affiliations
| Graduation year | 2011 |
|---|---|
| Medicare specialty | Registered Dietitian Or Nutrition Professional |
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