Provider Demographics
NPI:1124882725
Name:CHAVEZ, YANCI
Entity type:Individual
Prefix:
First Name:YANCI
Middle Name:
Last Name:CHAVEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11121 KIRA CT
Mailing Address - Street 2:
Mailing Address - City:BEALETON
Mailing Address - State:VA
Mailing Address - Zip Code:22712-9391
Mailing Address - Country:US
Mailing Address - Phone:703-398-7032
Mailing Address - Fax:
Practice Address - Street 1:3541 CHAIN BRIDGE RD
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-2793
Practice Address - Country:US
Practice Address - Phone:703-218-3978
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-13
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst