Healthcare Provider Details

I. General information

NPI: 1912223306
Provider Name (Legal Business Name): SONAL JAGASIA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2010
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2220 CEDAR LN STE 100
TYSONS VA
22182-5251
US

IV. Provider business mailing address

2220 CEDAR LN STE 100
TYSONS VA
22182-5251
US

V. Phone/Fax

Practice location:
  • Phone: 571-368-6654
  • Fax: 571-368-6655
Mailing address:
  • Phone: 571-368-6654
  • Fax: 571-368-6655

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number0101256643
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD042640
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: