Provider Demographics
NPI:1396747812
Name:HEYRANA, JOSEFINA CABAHUG (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEFINA
Middle Name:CABAHUG
Last Name:HEYRANA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7914 WILLFIELD CT
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX STATION
Mailing Address - State:VA
Mailing Address - Zip Code:22039-3180
Mailing Address - Country:US
Mailing Address - Phone:703-643-2875
Mailing Address - Fax:
Practice Address - Street 1:7906 ANDRUS RD
Practice Address - Street 2:SUITE 8
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22306-3168
Practice Address - Country:US
Practice Address - Phone:703-780-7034
Practice Address - Fax:703-780-1379
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2011-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101051218207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA541895004OtherTIN
VA541895004OtherTIN
VA000M50A93Medicare ID - Type Unspecified