Provider Demographics
NPI:1003462953
Name:JAJAN, PAUL
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:JAJAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6269 LEESBURG PIKE STE 105
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22044-2103
Mailing Address - Country:US
Mailing Address - Phone:703-621-3187
Mailing Address - Fax:703-842-1194
Practice Address - Street 1:6269 LEESBURG PIKE STE 105
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22044-2103
Practice Address - Country:US
Practice Address - Phone:703-621-3187
Practice Address - Fax:703-842-1194
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-15
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite CareGroup - Multi-Specialty