{
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"FirstLineMailingAddress": "2800 PLAZA DEL AMO",
"SecondLineMailingAddress": "UNIT 213",
"MailingAddressCityName": "TORRANCE",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "90503-7388",
"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "15446 S WESTERN AVE",
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"PracticeLocationAddressCityName": "GARDENA",
"PracticeLocationAddressStateName": "CA",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "310-217-5378",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "10/05/2006",
"LastUpdateDate": "12/21/2021",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Physical Therapist",
"LicenseNumber": "PT32087",
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}