Provider Demographics
NPI:1801600523
Name:DJEBBARI, YOUSSEF
Entity type:Individual
Prefix:
First Name:YOUSSEF
Middle Name:
Last Name:DJEBBARI
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7900 SUDLEY RD STE 376
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20109-2886
Mailing Address - Country:US
Mailing Address - Phone:703-568-2559
Mailing Address - Fax:855-853-6635
Practice Address - Street 1:7900 SUDLEY RD STE 376
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20109-2886
Practice Address - Country:US
Practice Address - Phone:703-568-2559
Practice Address - Fax:855-853-6635
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-04
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO-005691251E00000X, 385H00000X, 385HR2060X, 163WH0200X, 385HR2065X, 374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No251E00000XAgenciesHome Health
No385H00000XRespite Care FacilityRespite Care
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child