{
"Npi": {
"NPI": "1336593334",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "BROUSSEAU",
"FirstName": "KAREN",
"MiddleName": "A",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "RPH",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "3499 INDIAN RIDGE CIR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "THOUSAND OAKS",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "91362-4949",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "805-241-9712",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "2220 LYNN RD",
"SecondLinePracticeLocationAddress": "STE 100",
"PracticeLocationAddressCityName": "THOUSAND OAKS",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "91360-1904",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "805-495-1015",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/16/2016",
"LastUpdateDate": "04/16/2016",
"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": "1835P0018X",
"TaxonomyName": "Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"LicenseNumber": "46645",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}