{
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"FirstLineMailingAddress": "PO BOX 2462",
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"MailingAddressCityName": "CAPISTRANO BEACH",
"MailingAddressStateName": "CA",
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"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "34052 LA PLAZA STE 107",
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"PracticeLocationAddressCityName": "DANA POINT",
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"PracticeLocationAddressCountryCode": "US",
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"EnumerationDate": "08/29/2006",
"LastUpdateDate": "03/25/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": "10/04/2019",
"NPIReactivationDate": "03/25/2020",
"GenderCode": "F",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Marriage & Family Therapist",
"LicenseNumber": "46663",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}