Provider Demographics
NPI:1811448327
Name:ESTEVES, SANDRA CARINA (PA-C)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:CARINA
Last Name:ESTEVES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8454 GREAT LAKE LN
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22153-4004
Mailing Address - Country:US
Mailing Address - Phone:703-508-4920
Mailing Address - Fax:
Practice Address - Street 1:8605 WESTWOOD CENTER DR
Practice Address - Street 2:SUITE 201
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-2240
Practice Address - Country:US
Practice Address - Phone:703-712-8343
Practice Address - Fax:703-712-8344
Is Sole Proprietor?:No
Enumeration Date:2016-10-19
Last Update Date:2017-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110005429363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant