{
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"FirstLineMailingAddress": "317 W VENTURA BLVD # 1026",
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"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "310-748-3668",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "317 W VENTURA BLVD # 1026",
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"PracticeLocationAddressCityName": "CAMARILLO",
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"EnumerationDate": "09/29/2020",
"LastUpdateDate": "11/12/2021",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "COLBY",
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"AuthorizedOfficialCredential": "PH.D.",
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"TaxonomyName": "Primary Care Clinic/Center",
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}