{
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"FirstLineMailingAddress": "PO BOX 4431",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LAGUNA BEACH",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92652-4431",
"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "1810 N MAIN ST",
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"PracticeLocationAddressCityName": "SANTA ANA",
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"EnumerationDate": "05/26/2009",
"LastUpdateDate": "05/26/2009",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
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"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "106H00000X",
"TaxonomyName": "Marriage & Family Therapist",
"LicenseNumber": "MFC 24321",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}