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1063672574 NPI number — JENNIFER MUNOZ

NPI Number: 1063672574
Health Care Provider/Practitioner: JENNIFER MUNOZ

Information about “1063672574” NPI (JENNIFER MUNOZ) exists in 1063672574 in HTML format HTML  |  1063672574 in plain Text format TXT  |  1063672574 in PDF (Portable Document Format) PDF  |  1063672574 in an XML format XML  formats.

NPI Number : 1063672574 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1063672574",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MUNOZ",
    "FirstName": "JENNIFER",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "ROSADO",
    "OtherFirstName": "JENNIFER",
    "OtherMiddleName": "E",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "1415 WEST, NC-54 BUILDING 200, SUITE 210",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "DURHAM",
    "MailingAddressStateName": "NC",
    "MailingAddressPostalCode": "27707",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "73-109-2694",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1415 WEST, NC-54 SUITE 210",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "DURHAM",
    "PracticeLocationAddressStateName": "NC",
    "PracticeLocationAddressPostalCode": "27707",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "407-310-9269",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "06/10/2008",
    "LastUpdateDate": "09/01/2021",
    "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": "103T00000X",
          "TaxonomyName": "Psychologist",
          "LicenseNumber": "P7219",
          "LicenseNumberStateCode": "OH",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "390200000X",
          "TaxonomyName": "Student in an Organized Health Care Education/Training Program",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "103TC2200X",
          "TaxonomyName": "Clinical Child & Adolescent Psychologist",
          "LicenseNumber": "5930",
          "LicenseNumberStateCode": "NC",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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