{
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"FirstLineMailingAddress": "3020 CHILDRENS WAY # MC6043",
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"MailingAddressCityName": "SAN DIEGO",
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"FirstLinePracticeLocationAddress": "25170 HANCOCK AVE",
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"PracticeLocationAddressCityName": "MURRIETA",
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"PracticeLocationAddressTelephoneNumber": "858-757-3277",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "12/03/2013",
"LastUpdateDate": "05/04/2022",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Marriage & Family Therapist",
"LicenseNumber": "IMF79230",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}