Provider Demographics
NPI:1699652172
Name:CACACE, KASEY MARIE (RDN)
Entity type:Individual
Prefix:
First Name:KASEY
Middle Name:MARIE
Last Name:CACACE
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2230 JERROLD AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94124-1012
Mailing Address - Country:US
Mailing Address - Phone:650-346-4485
Mailing Address - Fax:650-346-4485
Practice Address - Street 1:2230 JERROLD AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94124-1012
Practice Address - Country:US
Practice Address - Phone:650-346-4485
Practice Address - Fax:650-346-4485
Is Sole Proprietor?:No
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA459879133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered