{
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"FirstLineMailingAddress": "4720 E SAN GABRIEL AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "FRESNO",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "93726-1838",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "559-375-3308",
"MailingAddressFaxNumber": "559-400-6671",
"FirstLinePracticeLocationAddress": "1420 W SHAW AVE STE A",
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"PracticeLocationAddressCityName": "FRESNO",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "559-521-3321",
"PracticeLocationAddressFaxNumber": "559-400-6671",
"EnumerationDate": "09/02/2026",
"LastUpdateDate": "09/03/2026",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "AGUILAR",
"AuthorizedOfficialFirstName": "SHIRLEY",
"AuthorizedOfficialMiddleName": "L",
"AuthorizedOfficialTitle": "OWNER/ MASSAGE THERAPIST",
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"AuthorizedOfficialCredential": "CMT",
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"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "225700000X",
"TaxonomyName": "Massage Therapist",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
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"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}