{
"Npi": {
"NPI": "1194464446",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "WORKFORCE PHYSICAL THERAPY",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "142 N MILPITAS BLVD # 398",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MILPITAS",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "95035-4401",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "408-931-2493",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "484 OAK RD RM 206",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "STANFORD",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "94305-4502",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "650-684-8974",
"PracticeLocationAddressFaxNumber": "408-608-1993",
"EnumerationDate": "06/02/2022",
"LastUpdateDate": "06/02/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BANAFA",
"AuthorizedOfficialFirstName": "ABDULHAMID",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CEO",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PT",
"AuthorizedOfficialTelephoneNumber": "408-931-2493",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "225100000X",
"TaxonomyName": "Physical Therapist",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}