Provider Demographics
NPI:1205020229
Name:HERRERA, JAMES FERNANDO (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:FERNANDO
Last Name:HERRERA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1497 CHAIN BRIDGE RD
Mailing Address - Street 2:105
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-5728
Mailing Address - Country:US
Mailing Address - Phone:703-749-1234
Mailing Address - Fax:703-749-1209
Practice Address - Street 1:1497 CHAIN BRIDGE RD
Practice Address - Street 2:105
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-5728
Practice Address - Country:US
Practice Address - Phone:703-749-1234
Practice Address - Fax:703-749-1209
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-03
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA01012388262084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry