Provider Demographics
NPI:1306009899
Name:OSTERHAUS, JAMES PETER (PHD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:PETER
Last Name:OSTERHAUS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3541 CHAIN BRIDGE RD STE 6
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-2793
Mailing Address - Country:US
Mailing Address - Phone:703-352-0660
Mailing Address - Fax:703-385-9621
Practice Address - Street 1:3541 CHAIN BRIDGE RD STE 6
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-2793
Practice Address - Country:US
Practice Address - Phone:703-352-0660
Practice Address - Fax:703-385-9621
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-07
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810002345103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist