Daria Jacob, RDN

Individual provider Active NPI Registered Dietitian · Hollywood, CA

NPI 1194486746 · NPPES record last updated May 20, 2023

Key facts

NPI
1194486746
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
Practice address
1763 N Gower St
Hollywood, CA 90028-5423
Phone
(562) 424-4055
NPI assigned
Jan 5, 2022
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Omnicare Medical Group, Inc Past
since May 21, 2023
Accepting new patients
Nutrition As Therapy Inc. Dietitian, Registered Past
since May 21, 2023
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X Yes

Addresses

Primary practice location

1763 N Gower St
Hollywood, CA 90028-5423

Mailing address

42 Southgate Dr
Annandale, NJ 08801-3386

Other providers in Hollywood, CA

All providers in Hollywood, CA · Registered Dietitian in California

Sources for this page

Verify at the official NPI Registry.