{
"Npi": {
"NPI": "1003091638",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "EILERS",
"FirstName": "ELISABETH",
"MiddleName": "CAVIN",
"NamePrefix": "MS.",
"NameSuffix": null,
"Credential": "MFT",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "CAVIN",
"OtherFirstName": "ELIZABETH",
"OtherMiddleName": "IRENE",
"OtherNamePrefix": "MS.",
"OtherNameSuffix": null,
"OtherCredential": "MFT",
"OtherLastNameTypeCode": "5",
"FirstLineMailingAddress": "446 S MARENGO AVE",
"SecondLineMailingAddress": "SUITE B",
"MailingAddressCityName": "PASADENA",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "91101-3113",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "626-375-8140",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "446 S MARENGO AVE",
"SecondLinePracticeLocationAddress": "SUITE B",
"PracticeLocationAddressCityName": "PASADENA",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "91101-3113",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "626-375-8140",
"PracticeLocationAddressFaxNumber": "626-403-9333",
"EnumerationDate": "01/02/2008",
"LastUpdateDate": "03/04/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "106H00000X",
"TaxonomyName": "Marriage & Family Therapist",
"LicenseNumber": "MF23908",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}