{
"Npi": {
"NPI": "1255638482",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "SCHIBSTED",
"FirstName": "PENELOPE",
"MiddleName": "A",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "MFT",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "SCHIBSTED",
"OtherFirstName": "PENELOPE",
"OtherMiddleName": "ANNE",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "RN",
"OtherLastNameTypeCode": "5",
"FirstLineMailingAddress": "PO BOX 96",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SUNSET BEACH",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "90742-0096",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "714-928-5049",
"MailingAddressFaxNumber": "714-835-8848",
"FirstLinePracticeLocationAddress": "1401 N TUSTIN AVE",
"SecondLinePracticeLocationAddress": "SUITE 300",
"PracticeLocationAddressCityName": "SANTA ANA",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "92705-8644",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "714-835-8819",
"PracticeLocationAddressFaxNumber": "714-835-8848",
"EnumerationDate": "02/24/2011",
"LastUpdateDate": "02/24/2011",
"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": "106H00000X",
"TaxonomyName": "Marriage & Family Therapist",
"LicenseNumber": "40756",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "163W00000X",
"TaxonomyName": "Registered Nurse",
"LicenseNumber": "294961",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}