Provider Demographics
NPI:1295412039
Name:GIRGIS, JACENTA (BCBA)
Entity type:Individual
Prefix:
First Name:JACENTA
Middle Name:
Last Name:GIRGIS
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9450 FAIRFAX BLVD APT 1316
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-2414
Mailing Address - Country:US
Mailing Address - Phone:630-822-0080
Mailing Address - Fax:
Practice Address - Street 1:9450 FAIRFAX BLVD APT 1316
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-2414
Practice Address - Country:US
Practice Address - Phone:630-822-0080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-03
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst