Provider Demographics
NPI:1659605699
Name:DE VILLEGAS-DECKER, RAUL (PSYD)
Entity Type:Individual
Prefix:DR
First Name:RAUL
Middle Name:
Last Name:DE VILLEGAS-DECKER
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12214 RAINY DAY WAY
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20155-3858
Mailing Address - Country:US
Mailing Address - Phone:703-786-3088
Mailing Address - Fax:
Practice Address - Street 1:10650 PAGE AVE
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-4004
Practice Address - Country:US
Practice Address - Phone:703-246-2808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-23
Last Update Date:2009-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810004098103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical