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1295004703 NPI number — ROSSIO CABRERA LANDEROS B.S.

NPI Number: 1295004703
Health Care Provider/Practitioner: ROSSIO CABRERA LANDEROS B.S.

Information about “1295004703” NPI (ROSSIO CABRERA LANDEROS B.S.) exists in 1295004703 in HTML format HTML  |  1295004703 in plain Text format TXT  |  1295004703 in PDF (Portable Document Format) PDF  |  1295004703 in an XML format XML  formats.

NPI Number : 1295004703 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1295004703",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "LANDEROS",
    "FirstName": "ROSSIO",
    "MiddleName": "CABRERA",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "B.S.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "11848 CARLISLE AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CHINO",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "91710-1704",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "626-484-6544",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "301 E ARROW HWY STE 101",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SAN DIMAS",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "91773-3364",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "909-293-7854",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "12/29/2011",
    "LastUpdateDate": "02/12/2014",
    "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": "101Y00000X",
          "TaxonomyName": "Counselor",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "225400000X",
          "TaxonomyName": "Rehabilitation Practitioner",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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