{
"Npi": {
"NPI": "1255456620",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "VARGAS",
"FirstName": "TRACI",
"MiddleName": "RENEE",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "NP",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "GORMAN",
"OtherFirstName": "TRACI",
"OtherMiddleName": "RENEE",
"OtherNamePrefix": "MISS",
"OtherNameSuffix": null,
"OtherCredential": "RN",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "10418 VALLEY BLVD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "EL MONTE",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "91731-3600",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "626-453-8466",
"MailingAddressFaxNumber": "626-453-8465",
"FirstLinePracticeLocationAddress": "10418 VALLEY BLVD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "EL MONTE",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "91731-3600",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "626-453-8466",
"PracticeLocationAddressFaxNumber": "626-453-8465",
"EnumerationDate": "03/21/2007",
"LastUpdateDate": "06/06/2012",
"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": "163W00000X",
"TaxonomyName": "Registered Nurse",
"LicenseNumber": "462956",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363LW0102X",
"TaxonomyName": "Women's Health Nurse Practitioner",
"LicenseNumber": "16153",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}