Healthcare Provider Details

I. General information

NPI: 1235024480
Provider Name (Legal Business Name): ASIA LORENE SYKES-FERNANDO PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2025
Last Update Date: 06/10/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3302 GALLOWS RD
FALLS CHURCH VA
22042-3353
US

IV. Provider business mailing address

9319 LANCELOT RD
FORT WASHINGTON MD
20744-5626
US

V. Phone/Fax

Practice location:
  • Phone: 703-207-7100
  • Fax:
Mailing address:
  • Phone: 757-567-6459
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0810008956
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: