Healthcare Provider Details

I. General information

NPI: 1659131647
Provider Name (Legal Business Name): JOU HOU LAU PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/19/2024
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1629 K ST NW STE 300
WASHINGTON DC
20006-1631
US

IV. Provider business mailing address

10304 EATON PL STE 100
FAIRFAX VA
22030-2221
US

V. Phone/Fax

Practice location:
  • Phone: 571-463-8620
  • Fax: 571-999-7549
Mailing address:
  • Phone: 571-463-8620
  • Fax: 571-999-7549

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0024189763
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: