Provider Demographics
NPI:1003567868
Name:RODRIGUEZ LUJAN, XIMENA NATALIA (LAT, ATC)
Entity Type:Individual
Prefix:
First Name:XIMENA
Middle Name:NATALIA
Last Name:RODRIGUEZ LUJAN
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4501 HAZELTINE CT UNIT D
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22312-3202
Mailing Address - Country:US
Mailing Address - Phone:202-341-7239
Mailing Address - Fax:
Practice Address - Street 1:2955 S GLEBE RD STE E
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22206-2730
Practice Address - Country:US
Practice Address - Phone:703-535-8887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-13
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01260031832255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer