{
"Npi": {
"NPI": "1326968611",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "ANGEL",
"FirstName": "ERIKA",
"MiddleName": "DANAE",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "BULTHUIS",
"OtherFirstName": "ERIKA",
"OtherMiddleName": "DANAE",
"OtherNamePrefix": "MISS",
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "2655 CAMINO DEL RIO N.",
"SecondLineMailingAddress": "SUITE 450",
"MailingAddressCityName": "SAN DIEGO",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92108",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "619-633-4115",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "2655 CAMINO DEL RIO N. SUITE 450",
"SecondLinePracticeLocationAddress": "SUITE 450",
"PracticeLocationAddressCityName": "SAN DIEGO",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "92108",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "619-633-4115",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "07/17/2026",
"LastUpdateDate": "07/17/2026",
"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": "373H00000X",
"TaxonomyName": "Day Training/Habilitation Specialist",
"LicenseNumber": "373H00000X",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}