Healthcare Provider Details

I. General information

NPI: 1790193662
Provider Name (Legal Business Name): YAFFI LVOVA RDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2014
Last Update Date: 08/22/2025
Certification Date: 08/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2345 E THOMAS RD STE 100
PHOENIX AZ
85016-7858
US

IV. Provider business mailing address

2345 E THOMAS RD STE 100
PHOENIX AZ
85016-7858
US

V. Phone/Fax

Practice location:
  • Phone: 480-231-1082
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number1090285
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number1090285
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: