Provider Demographics
NPI:1477384980
Name:SIFUENTES CACERES, FIORELLA YANINA
Entity type:Individual
Prefix:
First Name:FIORELLA
Middle Name:YANINA
Last Name:SIFUENTES CACERES
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 1:1425 S EADS ST APT 1102
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22202-2851
Mailing Address - Country:US
Mailing Address - Phone:202-677-9604
Mailing Address - Fax:
Practice Address - Street 1:1419 COLUMBIA RD NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-4705
Practice Address - Country:US
Practice Address - Phone:202-386-2688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-08
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC200001805101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor