{
"Npi": {
"NPI": "1104295732",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "CENTRAL COAST THERAPY",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1104 VINE ST",
"SecondLineMailingAddress": "SUITE A",
"MailingAddressCityName": "PASO ROBLES",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "93446-5502",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "805-591-7234",
"MailingAddressFaxNumber": "805-259-4720",
"FirstLinePracticeLocationAddress": "1104 VINE ST",
"SecondLinePracticeLocationAddress": "SUITE A",
"PracticeLocationAddressCityName": "PASO ROBLES",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "93446-5502",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "805-591-7234",
"PracticeLocationAddressFaxNumber": "805-259-4720",
"EnumerationDate": "09/24/2015",
"LastUpdateDate": "09/24/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BRANCH",
"AuthorizedOfficialFirstName": "MICHELLE",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "805-423-7207",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251S00000X",
"TaxonomyName": "Community/Behavioral Health Agency",
"LicenseNumber": "MFC50213",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}