{
"Npi": {
"NPI": "1124909866",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "VEGA",
"FirstName": "MARINA",
"MiddleName": "LYNN",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "AMFT",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "VEGA",
"OtherFirstName": "MARINA",
"OtherMiddleName": "LYNN",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "AMFT",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "PO BOX 3004",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CERRITOS",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "90703-3004",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1021 E WALNUT ST STE 208",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PASADENA",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "91106-1453",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "818-570-1636",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "09/09/2025",
"LastUpdateDate": "10/02/2025",
"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": "106H00000X",
"TaxonomyName": "Marriage & Family Therapist",
"LicenseNumber": "157828",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}