Healthcare Provider Details

I. General information

NPI: 1396201349
Provider Name (Legal Business Name): PSYCHIATRIC ASSOCIATES OF CENTRAL VIRGINIA, P.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2019
Last Update Date: 02/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7427 BROOK ROAD SUITE 102
RICHMOND VA
23227-1816
US

IV. Provider business mailing address

7427 BROOK ROAD SUITE 102
RICHMOND VA
23227-1816
US

V. Phone/Fax

Practice location:
  • Phone: 804-301-5186
  • Fax: 804-673-6771
Mailing address:
  • Phone: 804-301-5186
  • Fax: 804-673-6771

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ANTONY FERNANDEZ
Title or Position: PRESIDENT, PSYCHIATRIC ASSOCIATES O
Credential: M.D.
Phone: 804-301-5186