{
"Npi": {
"NPI": "1174754576",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "MARTELLO",
"FirstName": "BONNIE",
"MiddleName": "E.",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "LMFT",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "HOLDER",
"OtherFirstName": "BONNIE",
"OtherMiddleName": "E.",
"OtherNamePrefix": "MRS.",
"OtherNameSuffix": null,
"OtherCredential": "LMFT",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "25830 OAK FOREST CT",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "COLFAX",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "95713-9460",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "530-320-2027",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "195 AGNES ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "AUBURN",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "95603-4710",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "530-320-2027",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "08/03/2009",
"LastUpdateDate": "08/03/2009",
"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": "36702",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}