Healthcare Provider Details

I. General information

NPI: 1720902190
Provider Name (Legal Business Name): HOSANA NAGASAKA CHAVEZ MPH, RD, LD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 LONGWOOD AVE
BOSTON MA
02115-5711
US

IV. Provider business mailing address

36 COLLEGE AVE APT B4
SOMERVILLE MA
02144-1959
US

V. Phone/Fax

Practice location:
  • Phone: 617-355-6000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number1670
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberLDN8949
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: