{
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"FirstLineMailingAddress": "68315 ESTIO RD",
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"FirstLinePracticeLocationAddress": "44100 MONTEREY AVE STE 218",
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"PracticeLocationAddressCityName": "PALM DESERT",
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"EnumerationDate": "09/18/2026",
"LastUpdateDate": "09/18/2026",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DELECTOR",
"AuthorizedOfficialFirstName": "GENELYN JOVE",
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"Taxonomies": {
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}