Healthcare Provider Details

I. General information

NPI: 1225590185
Provider Name (Legal Business Name): HONGJING CAO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JANIE CAO

II. Dates (important events)

Enumeration Date: 04/01/2019
Last Update Date: 11/21/2025
Certification Date: 11/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 160
CENTREVILLE VA
20122-0160
US

IV. Provider business mailing address

PO BOX 160
CENTREVILLE VA
20122-0160
US

V. Phone/Fax

Practice location:
  • Phone: 703-282-5209
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberMD210002453
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number13215320
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number0101285056
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: