{
"Npi": {
"NPI": "1134590680",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "CRAWFORD",
"FirstName": "ANDREW",
"MiddleName": "DAVID DAVILA",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "CATC-III",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "CRAWFORD",
"OtherFirstName": "ANDREW",
"OtherMiddleName": "DAVID DAVILA",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "2",
"FirstLineMailingAddress": "21 VIA HONRADO",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "RANCHO SANTA MARGARITA",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92688-1955",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "949-829-7130",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "14742 NEWPORT AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "TUSTIN",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "92780-6177",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "949-829-7130",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "10/09/2015",
"LastUpdateDate": "06/09/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "101YA0400X",
"TaxonomyName": "Addiction (Substance Use Disorder) Counselor",
"LicenseNumber": "196897-II",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}