Provider Demographics
NPI:1033745476
Name:LOYA, JENNIFER MABEL (MA)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MABEL
Last Name:LOYA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2251 PIMMIT DR APT 1034
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22043-2824
Mailing Address - Country:US
Mailing Address - Phone:301-642-1168
Mailing Address - Fax:
Practice Address - Street 1:3700 JOSEPH SIEWICK DR STE 408
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22033-1745
Practice Address - Country:US
Practice Address - Phone:703-391-3330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-17
Last Update Date:2020-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program