Active NPI
Jessica W Dezzutti, M.ED
- Behavior Analyst
- Herndon, VA
National Provider Identifier
1366726101
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 626 Grant St
Ste. 1
Herndon, VA 20170-4734 - Phone
- (703) 501-6921
- NPI assigned
- Sep 28, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Primary |
Addresses
Primary practice location
626 Grant St
Ste. 1
Herndon, VA 20170-4734
Mailing address
626 Grant St
Ste. 1
Herndon, VA 20170-4734
Phone (703) 501-6921
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Education
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1317168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317168000000",
"number": "1366726101",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "626 GRANT ST",
"address_2": "STE. 1",
"city": "HERNDON",
"state": "VA",
"postal_code": "201704734",
"telephone_number": "703-501-6921"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "626 GRANT ST",
"address_2": "STE. 1",
"city": "HERNDON",
"state": "VA",
"postal_code": "201704734",
"telephone_number": "703-501-6921"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEZZUTTI",
"first_name": "JESSICA",
"middle_name": "W",
"name_prefix": "Ms.",
"credential": "M.ED",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-09-28",
"last_updated": "2011-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Herndon, VA
- Tamar Aline Deradourian, M.S., BCBA
- Purvi Desai, PT
- Deshi Home Health Care, LLC (Deshi Home Health Care)
- Desi Farren C.a.C. & Associates (The Recovery Center of Northern Virginia)
- Behailu Zeleke Desta, RPH
- Subarna B Dharia, MD
- Diabetic Supplies Mid-Atlantic
- Carolyn Gayle Dibella, PTA
- Raven Elizabeth Dickerson, LCSW
- Kevin Diep, DPM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.