1285143008 NPI number — PSYCHIATRIC ASSOCIATES OF NORTHERN VIRGINIA

Table of content: PAMELA JOY WEBBER FNP (NPI 1891934543)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285143008 NPI number — PSYCHIATRIC ASSOCIATES OF NORTHERN VIRGINIA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PSYCHIATRIC ASSOCIATES OF NORTHERN VIRGINIA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1285143008
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/03/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
22038 AUCTION BARN DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ASHBURN
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
20148-4110
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
443-610-2615
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4229 LAFAYETTE CENTER DR STE 1760
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHANTILLY
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
20151-1267
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
443-610-2615
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/25/2017

Additional Information

Authorized Official

Authorized Official Last Name:
RIZVI
Authorized Official First Name:
SYED
Authorized Official Middle Name:
W H
Authorized Official Title or Position:
PSYCHIATRIST
Authorized Official Telephone Number:
443-610-2615

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X , with the licence number:  0101102350 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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