{
"Npi": {
"NPI": "1265820575",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "NEVAREZ-VIVOLO",
"FirstName": "DEBORAH",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "NEVAREZ",
"OtherFirstName": "DEBORAH",
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "14890 JEREMIE ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BALDWIN PARK",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "91706-5628",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "626-485-0424",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "21125 CENTRE POINTE PKWY",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SANTA CLARITA",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "91350-2994",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "855-435-3801",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/08/2015",
"LastUpdateDate": "03/13/2025",
"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": "122545",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}