Pepito Jimenez Decena Jr., LPN

Primary specialty

Home Health Clinical Nurse SpecialistTaxonomy code 364SH0200X

License

0002093395 Issued in VA

Practice address

13800 Coppermine Rd # 124-a
Herndon, VA 20171-6163

Phone

(571) 508-7144

Fax

(703) 935-0898

NPI assigned

Jul 20, 2020

Last updated

Jul 20, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Decena Home Care, LLC

  dba Decena Home Care

  • Personal Care Attendant
  • Herndon, VA
  • NPI 1831707561

  Home Health

  NPD Authorized official

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

{
    "created_epoch": "1595203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595203200000",
    "number": "1639787377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 W REDWOOD RD",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201645117",
            "telephone_number": "571-508-7144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13800 COPPERMINE RD # 124-A",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201716163",
            "telephone_number": "571-508-7144",
            "fax_number": "703-935-0898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECENA",
        "first_name": "PEPITO",
        "middle_name": "JIMENEZ",
        "name_suffix": "Jr.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-20",
        "last_updated": "2020-07-20",
        "certification_date": "2020-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SH0200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Home Health",
            "state": "VA",
            "license": "0002093395",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julie Canniffe Davis, LCAS, CSAC, CADC II
• Louise Eileen Davis, M.AC, DIPL.AC., L.AC
• Desiree Debutts Farren, CADC, ICADC
• Decena Home Care, LLC (Decena Home Care)
• Ma. Rose Jeminez Decena
• Bradley Jay Deck
• Heather Anne Deckelbaum, M.S., CCC
• Justina Megan Dee, D.C.
• Adele S Denny, MSW, LCSW
• Dental Center of Herndon

• Clinical Nurse Specialist in Herndon, VA
• Providers in Herndon, VA by specialty
• Clinical Nurse Specialist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2020; 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.