IndividualActive
Alice Thipphavong, MS, RD
NPI 1275982837 · Renal Nutrition Registered Dietitian · San Jose, CA
Provider details
- NPI number
- 1275982837
- Entity type
- Individual
- Primary specialty
- Renal Nutrition Registered DietitianDietary & Nutritional Service Providers
- Credential
- MS, RD
- Sex
- Female
- Sole proprietor
- Yes
- License
- R519736 (IL)
Specialties & taxonomies
Dietary & Nutritional Service Providers
Practice location
1290 Tully Rd Ste 60
San Jose, CA 95122-3069
Phone: (408) 275-0105
Fax: (408) 275-0115
Approximate (ZIP-level) locationGet directions
Mailing address
1131 Sabal Ct
San Jose, CA 95132-2866
Registry dates
- Enumerated
- 2016-06-05
- Last updated
- 2016-06-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.