{
"Npi": {
"NPI": "1114800950",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "LUCERO",
"FirstName": "ANJANETTE",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "CHW",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "117 CAMINO DE VIDA STE 300",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SANTA ROSA",
"MailingAddressStateName": "NM",
"MailingAddressPostalCode": "88435-2267",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "575-472-4311",
"MailingAddressFaxNumber": "877-651-0289",
"FirstLinePracticeLocationAddress": "1024 S PACIFIC ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LAS VEGAS",
"PracticeLocationAddressStateName": "NM",
"PracticeLocationAddressPostalCode": "87701-3415",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "505-426-2599",
"PracticeLocationAddressFaxNumber": "877-553-1272",
"EnumerationDate": "07/29/2025",
"LastUpdateDate": "07/29/2025",
"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": "172V00000X",
"TaxonomyName": "Community Health Worker",
"LicenseNumber": null,
"LicenseNumberStateCode": "NM",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}