1740203793 NPI number — DR. LINDA HAAS TARR PH.D.

Table of content: JESSICA ORTEGA (NPI 1699316737)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740203793 NPI number — DR. LINDA HAAS TARR PH.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TARR
Provider First Name:
LINDA
Provider Middle Name:
HAAS
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PH.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HAAS
Provider Other First Name:
LINDA
Provider Other Middle Name:
JOAN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1740203793
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5276 DAWES AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALEXANDRIA
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22311-1404
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-379-7350
Provider Business Mailing Address Fax Number:
703-379-7352

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5276 DAWES AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALEXANDRIA
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22311-1404
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-379-7350
Provider Business Practice Location Address Fax Number:
703-379-7352
Provider Enumeration Date:
07/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  0810002282 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 103TC0700X , with the licence number: PSY 1041 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 001296 . This is a "TRICARE, VALUE OPTIONS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 4890-0005 . This is a "CAREFIRST" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 11234162 . This is a "CAQH" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 215421 . This is a "MDIPA, MAMSI, OPTIMUM" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 117243 . This is a "KAISER" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 1819641 . This is a "FIRST HEALTH" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 247324 . This is a "ONE HEALTH PLAN" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 274469 . This is a "ANTHEM" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 78478 . This is a "UBH" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: PVPB6080 . This is a "APS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 718304 . This is a "NCPPO" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com