{
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"ReplacementNPI": null,
"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ST ANTHONY FOUNDATION",
"LastName": null,
"FirstName": null,
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"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "150 GOLDEN GATE AVE FL 2",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SAN FRANCISCO",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "94102-3810",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "415-241-8320",
"MailingAddressFaxNumber": "415-440-7776",
"FirstLinePracticeLocationAddress": "150 GOLDEN GATE AVE FL 2",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SAN FRANCISCO",
"PracticeLocationAddressStateName": "CA",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "415-241-8320",
"PracticeLocationAddressFaxNumber": "415-440-7776",
"EnumerationDate": "11/19/2010",
"LastUpdateDate": "03/02/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "VALDES",
"AuthorizedOfficialFirstName": "ANN",
"AuthorizedOfficialMiddleName": "CATHERINE",
"AuthorizedOfficialTitle": "MEDICAL DIRECTOR",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "415-592-2712",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "171M00000X",
"TaxonomyName": "Case Manager/Care Coordinator",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "261QP2300X",
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}
]
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}