Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kathy Bourque, RD

Individual provider Registered Dietitian · NPI 1629457171

Kathy Bourque, RD is a Registered Dietitian OR Nutrition Professional in Fremont, California. Qualified in 2011, 15 years ago. Licensed in California.

Years since qualifying
15
Licensed in
CA
In the registry since
2015
What do these letters mean?
RD — Registered Dietitian
A credentialed nutrition professional.

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Practice location Address checks out

5478 Ontario Cmn
Fremont, CA 94555-2928
Phone: (510) 648-2345
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Registered Dietitian (primary) Taxonomy 133V00000X · Licence 1066457 (CA)

Record details

NPI number1629457171
Entity typeIndividual (Type 1)
GenderFemale
Credentials RD
Sole proprietorNo
NPI enumeratedMay 29, 2015
Last updated in NPPESMay 29, 2015
Mailing address5478 Ontario Cmn, Fremont, CA 94555-2928

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyREGISTERED DIETITIAN OR NUTRITION PROFESSIONAL
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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