Individual provider Active NPI

Francisco Javier Cornejo

  • Clinical Social Worker
  • Manassas, VA
National Provider Identifier
1316717952
Registry record updated Jan 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904016175 Issued in VA
Practice address
9705 Liberia Ave Ste 201
Manassas, VA 20110-1744
Phone
(703) 680-7950
NPI assigned
Jan 4, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0904016175 VA Primary

Addresses

Primary practice location

9705 Liberia Ave Ste 201
Manassas, VA 20110-1744

Mailing address

9705 Liberia Ave Ste 201
Manassas, VA 20110-1744

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904016175VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Prince William Area Community Health Center Inc CurrentSince Mar 1, 2024 Accepting new patients
Greater Prince William Area Community Health Center Inc CurrentSince Mar 1, 2024 Accepting new patients

Locations

17739 Main St
Ste 130
Dumfries, VA 22026
Phone (703) 680-7950

9705 Liberia Ave
Ste 201
Manassas, VA 20110
Phone (703) 519-1725

3350 Commission Ct
Woodbridge, VA 22192
Phone (703) 680-7950

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1704326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704326400000",
    "number": "1316717952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9705 LIBERIA AVE STE 201",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201101744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9705 LIBERIA AVE STE 201",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201101744",
            "telephone_number": "703-680-7950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNEJO",
        "first_name": "FRANCISCO",
        "middle_name": "JAVIER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-04",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904016175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manassas, VA

Sources for this page

Verify at the official NPI Registry.