Healthcare Provider Details

I. General information

NPI: 1679410278
Provider Name (Legal Business Name): JESSICA BECKS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 COLTS NECK RD
RESTON VA
20191-2843
US

IV. Provider business mailing address

45750 DAYTON SQ APT 409
STERLING VA
20166-7031
US

V. Phone/Fax

Practice location:
  • Phone: 703-429-1130
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number0119011344
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: