{
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"FirstLineMailingAddress": "312 BRENTWOOD DR",
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"FirstLinePracticeLocationAddress": "13740 RESEARCH BLVD STE N8",
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"EnumerationDate": "08/18/2017",
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"NPIReactivationDate": null,
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"AuthorizedOfficialLastName": "BACA DAVILA",
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"Taxonomies": {
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"TaxonomyName": "Mental Health Clinic/Center (Including Community Mental Health Center)",
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}
},
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}
}