{
"Npi": {
"NPI": "1275079865",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "DEPARTMENT OF STATE HOSPITAL COALINGA",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "24511 W JAYNE AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "COALINGA",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "93210-9503",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "559-535-4300",
"MailingAddressFaxNumber": "559-934-3909",
"FirstLinePracticeLocationAddress": "24511 W JAYNE AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "COALINGA",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "93210-9503",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "559-535-4300",
"PracticeLocationAddressFaxNumber": "559-934-3909",
"EnumerationDate": "01/06/2017",
"LastUpdateDate": "01/06/2017",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "TRAN",
"AuthorizedOfficialFirstName": "TU",
"AuthorizedOfficialMiddleName": "VIET",
"AuthorizedOfficialTitle": "PHARMACIST 1",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PHARM. D",
"AuthorizedOfficialTelephoneNumber": "559-935-4300",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "283Q00000X",
"TaxonomyName": "Psychiatric Hospital",
"LicenseNumber": "RPH45269",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}