{
"Npi": {
"NPI": "1003105784",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "KOGAN-SBARBARO",
"FirstName": "LINA",
"MiddleName": null,
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "PHD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "KOGAN",
"OtherFirstName": "LINA",
"OtherMiddleName": null,
"OtherNamePrefix": "DR.",
"OtherNameSuffix": null,
"OtherCredential": "PHD",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "1050 UNIVERSITY AVE STE E107",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SAN DIEGO",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92103-3359",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "858-504-7743",
"MailingAddressFaxNumber": "858-216-1928",
"FirstLinePracticeLocationAddress": "1050 UNIVERSITY AVE STE E107",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SAN DIEGO",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "92103-3359",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "858-504-7743",
"PracticeLocationAddressFaxNumber": "858-216-1928",
"EnumerationDate": "04/01/2011",
"LastUpdateDate": "05/08/2022",
"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": "103TC0700X",
"TaxonomyName": "Clinical Psychologist",
"LicenseNumber": "PSY31866",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}