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1326704172 NPI number — MISS EVELYN CAROLINA CRUZ RODRIGUEZ

NPI Number: 1326704172
Health Care Provider/Practitioner: MISS EVELYN CAROLINA CRUZ RODRIGUEZ

Information about “1326704172” NPI (MISS EVELYN CAROLINA CRUZ RODRIGUEZ) exists in 1326704172 in HTML format HTML  |  1326704172 in plain Text format TXT  |  1326704172 in PDF (Portable Document Format) PDF  |  1326704172 in an XML format XML  formats.

NPI Number : 1326704172 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1326704172",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "CRUZ RODRIGUEZ",
    "FirstName": "EVELYN",
    "MiddleName": "CAROLINA",
    "NamePrefix": "MISS",
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "CRUZ RODRIGUEZ",
    "OtherFirstName": "EVELYN",
    "OtherMiddleName": "CAROLINA",
    "OtherNamePrefix": "MISS",
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "1380 CALLE GOMERO",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "THOUSAND OAKS",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "91360-6626",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "805-405-9402",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "3825 E THOUSAND OAKS BLVD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "WESTLAKE VILLAGE",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "91362-3639",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "805-497-3614",
    "PracticeLocationAddressFaxNumber": "805-497-0524",
    "EnumerationDate": "11/15/2021",
    "LastUpdateDate": "11/15/2021",
    "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": "183700000X",
        "TaxonomyName": "Pharmacy Technician",
        "LicenseNumber": "165441",
        "LicenseNumberStateCode": "CA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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