Healthcare Provider Details

I. General information

NPI: 1184512428
Provider Name (Legal Business Name): DARIA IAKOVISHINA MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DARIA PAPPAS MS

II. Dates (important events)

Enumeration Date: 06/25/2025
Last Update Date: 06/25/2025
Certification Date: 06/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1931 JONES ST UNIT B
SAN FRANCISCO CA
94133-2561
US

IV. Provider business mailing address

1931 JONES ST UNIT B
SAN FRANCISCO CA
94133-2561
US

V. Phone/Fax

Practice location:
  • Phone: 201-673-4526
  • Fax:
Mailing address:
  • Phone: 201-673-4526
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: