{
"Npi": {
"NPI": "1194011452",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "CABALLERO-GIPPSON",
"FirstName": "EDESTHER",
"MiddleName": "ALEJANDRA",
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "GIPPSON",
"OtherFirstName": "CABALLERO",
"OtherMiddleName": null,
"OtherNamePrefix": "DR.",
"OtherNameSuffix": null,
"OtherCredential": "P.H. D.",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "368 AVE DE DIEGO",
"SecondLineMailingAddress": "CRYSTAL HOUSE APT 602",
"MailingAddressCityName": "RIO PIEDRAS",
"MailingAddressStateName": "PR",
"MailingAddressPostalCode": "00923-2916",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "787-530-6633",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "PMB 410 DE DIEGO AVE 89",
"SecondLinePracticeLocationAddress": "SUITE 105",
"PracticeLocationAddressCityName": "SAN JUAN",
"PracticeLocationAddressStateName": "PR",
"PracticeLocationAddressPostalCode": "00927",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "787-530-6633",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "06/24/2011",
"LastUpdateDate": "07/08/2011",
"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": "103TC0700X",
"TaxonomyName": "Clinical Psychologist",
"LicenseNumber": "3988",
"LicenseNumberStateCode": "PR",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}