{
"Npi": {
"NPI": "1215166640",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "VILLARICO",
"FirstName": "ELIZABETH",
"MiddleName": "E.",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "M.D.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "3800 DALE ROAD",
"SecondLineMailingAddress": "KAISER PERMANENTE MODESTO OFFICE",
"MailingAddressCityName": "MODESTO",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "95356",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "209-739-4130",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "3800 DALE RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MODESTO",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "95356-8627",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "209-739-4130",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "07/07/2009",
"LastUpdateDate": "02/11/2022",
"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": "207Q00000X",
"TaxonomyName": "Family Medicine Physician",
"LicenseNumber": "A121521",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "207QA0505X",
"TaxonomyName": "Adult Medicine Physician",
"LicenseNumber": "A121521",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}