Provider Demographics
NPI:1881318574
Name:DADASOVICH, NICOLE (MA, MFT)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:DADASOVICH
Suffix:
Gender:F
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1565 OAK ST APT 3
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94117-2073
Mailing Address - Country:US
Mailing Address - Phone:415-644-8928
Mailing Address - Fax:
Practice Address - Street 1:1565 OAK ST APT 3
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94117-2073
Practice Address - Country:US
Practice Address - Phone:415-644-8928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-27
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist