{
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"FirstLineMailingAddress": "616 SISKIYOU BLVD",
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"MailingAddressCityName": "ASHLAND",
"MailingAddressStateName": "OR",
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"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "2021 FILLMORE ST",
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"PracticeLocationAddressCityName": "SAN FRANCISCO",
"PracticeLocationAddressStateName": "CA",
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"PracticeLocationAddressTelephoneNumber": "415-691-7026",
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"EnumerationDate": "09/07/2022",
"LastUpdateDate": "09/07/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
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"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "106H00000X",
"TaxonomyName": "Marriage & Family Therapist",
"LicenseNumber": "106982",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}