Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Damon J Licari, PA

Individual provider Physician Assistant · NPI 1962495069

Damon J Licari, PA is a Physician Assistant in Fairfax, Virginia. Works from 3 locations. Licensed in Virginia.

Licensed in
VA
In the registry since
2005
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

8081 Innovation Park Dr Ste 602
Fairfax, VA 22031-4867
Phone: (571) 472-3270
Fax: (571) 472-3271
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 3020 Hamaker Ct Ste 101, Fairfax, VA 22031-2233 — (703) 289-9400
  • 3300 Gallows Rd, Falls Church, VA 22042-3307 — (703) 776-4001

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0110001250 (VA)

Record details

NPI number1962495069
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedAugust 24, 2005
Last updated in NPPESMarch 15, 2022
Certification dateMarch 15, 2022

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