{
"Npi": {
"NPI": "1265811509",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "PEREIRA",
"FirstName": "CRYSTAL",
"MiddleName": "ANNETTE",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "LMFT",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "NEWTON",
"OtherFirstName": "CRYSTAL",
"OtherMiddleName": "ANNETTE",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "PO BOX 42171",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BAKERSFIELD",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "93384-2171",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "661-319-1832",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1430 TRUXTUN AVE",
"SecondLinePracticeLocationAddress": "FLOOR 5",
"PracticeLocationAddressCityName": "BAKERSFIELD",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "93301-5246",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "661-665-6077",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "05/19/2015",
"LastUpdateDate": "11/13/2020",
"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": "IMF85762",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "106H00000X",
"TaxonomyName": "Marriage & Family Therapist",
"LicenseNumber": "LMFT119392",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}