{
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"FirstLineMailingAddress": "2600 DALLAS PKWY STE 290",
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"FirstLinePracticeLocationAddress": "350 BOLLINGER CANYON LN",
"SecondLinePracticeLocationAddress": "STE A",
"PracticeLocationAddressCityName": "SAN RAMON",
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"PracticeLocationAddressTelephoneNumber": "925-735-6414",
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"EnumerationDate": "12/14/2009",
"LastUpdateDate": "06/06/2024",
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"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PACE",
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"AuthorizedOfficialTelephoneNumber": "213-804-1712",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Physical Therapist",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}