Individual provider Active NPI

Vianca Paola Escudero Sopena, PSY D

  • Clinical Psychologist
  • Arlington, VA
National Provider Identifier
1376167338
Registry record updated Apr 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0810008242 Issued in VA
Practice address
1530 Wilson Blvd Ste 360
Arlington, VA 22209-2466
Phone
(571) 600-6736
NPI assigned
Jun 4, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 0810008242 VA Primary

Addresses

Primary practice location

1530 Wilson Blvd Ste 360
Arlington, VA 22209-2466

Mailing address

1530 Wilson Blvd Ste 360
Arlington, VA 22209-2466
Phone (571) 600-6736

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

State licenses

LicenseStateTypeSpecialty
0810008242VAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1591228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712275200000",
    "number": "1376167338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 WILSON BLVD STE 360",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222092466",
            "telephone_number": "571-600-6736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 WILSON BLVD STE 360",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222092466",
            "telephone_number": "571-600-6736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESCUDERO SOPENA",
        "first_name": "VIANCA",
        "middle_name": "PAOLA",
        "name_prefix": "Dr.",
        "credential": "PSY D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-04",
        "last_updated": "2024-04-05",
        "certification_date": "2024-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810008242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.