Jacklyn Wang, RDN
NPI 1720884380ActiveIndividual· Dietitian, Registered· Provo, UT
Dietitian, Registered (RDN) in Provo, Utah, licensed in UT, with an NPI issued in February 2025.
Overview
| NPI | 1720884380 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | RDN |
| Sole proprietor | Yes |
| NPI issued | Feb 24, 2025 |
| Last updated in NPPES | Feb 24, 2025 |
| Certified by provider | Feb 23, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dietitian, Registered Primary | 133V00000X | 14196615-4901 | UT |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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