Active NPI
Alvin Wei Qi Phua, PSY.D.
- Clinical Psychologist
- Sterling, VA
National Provider Identifier
1679310239
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 0810008479
- Practice address
- 45154 Underwood LN
Sterling, VA 20166-2300 - Phone
- (571) 581-4997
- NPI assigned
- Jul 11, 2024
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 0810008479 | VA | Primary |
Addresses
Primary practice location
45154 Underwood LN
Sterling, VA 20166-2300
Mailing address
PO Box 1894
Herndon, VA 20172-1894
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0810008479 | VA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1720656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720656000000",
"number": "1679310239",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1894",
"city": "HERNDON",
"state": "VA",
"postal_code": "201721894"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "45154 UNDERWOOD LN",
"city": "STERLING",
"state": "VA",
"postal_code": "201662300",
"telephone_number": "571-581-4997"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHUA",
"first_name": "ALVIN",
"middle_name": "WEI QI",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-07-11",
"last_updated": "2024-07-11",
"certification_date": "2024-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "VA",
"license": "0810008479",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sterling, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 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.