{
"Npi": {
"NPI": "1336790690",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "SHERZADA",
"FirstName": "ANGELITA",
"MiddleName": "M",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "LCSW",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "SHERZADA",
"OtherFirstName": "ANGELA",
"OtherMiddleName": "M",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "LCSW",
"OtherLastNameTypeCode": "5",
"FirstLineMailingAddress": "1534 WELLS AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CLAREMONT",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "91711-3341",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "626-622-0638",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "250 W. FIRST STREET",
"SecondLinePracticeLocationAddress": "242",
"PracticeLocationAddressCityName": "CLAREMONT",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "91711",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "626-622-0638",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "09/26/2019",
"LastUpdateDate": "09/26/2019",
"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": "1041C0700X",
"TaxonomyName": "Clinical Social Worker",
"LicenseNumber": "82849",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}