Active NPI
Jessica Aysanoa, BS
- Behavior Analyst
- Woodbridge, VA
National Provider Identifier
1891040986
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 12656 Lake Ridge Dr Ste C
Woodbridge, VA 22192-7504 - Phone
- (703) 910-4362
- Fax
- (703) 910-4367
- NPI assigned
- Jul 16, 2012
- Sex
- Female
- Sole proprietor
- No
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
12656 Lake Ridge Dr Ste C
Woodbridge, VA 22192-7504
Mailing address
9214 Dorothy LN
Springfield, VA 22153-1618
Phone (703) 910-4362
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
- Bachelor of Science
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Behavioral Consulting Services | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Woodbridge, VA
- NPI 1417320797
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1342396800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1342396800000",
"number": "1891040986",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9214 DOROTHY LN",
"city": "SPRINGFIELD",
"state": "VA",
"postal_code": "221531618",
"telephone_number": "703-910-4362",
"fax_number": "703-910-4367"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12656 LAKE RIDGE DR STE C",
"city": "WOODBRIDGE",
"state": "VA",
"postal_code": "221927504",
"telephone_number": "703-910-4362",
"fax_number": "703-910-4367"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AYSANOA",
"first_name": "JESSICA",
"credential": "BS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-16",
"last_updated": "2012-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodbridge, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.