Provider Demographics
NPI:1518142660
Name:VILLEGAS, VALERIE M (PA)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:M
Last Name:VILLEGAS
Suffix:
Gender:F
Credentials:PA
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:8101 HINSON FARM RD
Mailing Address - Street 2:STE 301
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22306-3403
Mailing Address - Country:US
Mailing Address - Phone:703-765-4321
Mailing Address - Fax:703-780-4558
Practice Address - Street 1:8101 HINSON FARM RD
Practice Address - Street 2:STE 301
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22306-3403
Practice Address - Country:US
Practice Address - Phone:703-765-4321
Practice Address - Fax:703-780-4558
Is Sole Proprietor?:No
Enumeration Date:2008-01-08
Last Update Date:2021-06-03
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Provider Licenses
StateLicense IDTaxonomies
VA0110002399363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
174358YZWOtherDC MEDICARE