NPI Code Detail JSON Logo

1124788369 NPI number — BLOSSOMING HEALTH

NPI Number: 1124788369
Health Care Provider/Practitioner: BLOSSOMING HEALTH

Information about “1124788369” NPI (BLOSSOMING HEALTH) exists in 1124788369 in HTML format HTML  |  1124788369 in plain Text format TXT  |  1124788369 in PDF (Portable Document Format) PDF  |  1124788369 in an XML format XML  formats.

NPI Number : 1124788369 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1124788369",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "BLOSSOMING HEALTH",
    "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": "101 W WEDDELL DR APT 241",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SUNNYVALE",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "94089-1580",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "830 STEWART DR # 140",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SUNNYVALE",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "94085-4513",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "650-554-0753",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "12/29/2021",
    "LastUpdateDate": "12/29/2021",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "ALDINE",
    "AuthorizedOfficialFirstName": "ALIAA",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "OWNER",
    "AuthorizedOfficialNamePrefix": "DR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "LAC, DAOM",
    "AuthorizedOfficialTelephoneNumber": "650-554-0753",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "261QC1500X",
        "TaxonomyName": "Community Health Clinic/Center",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.