{
"Npi": {
"NPI": "1366680639",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "KAISER PERMANENTE",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1708 ESPLANADE APT 10",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "REDONDO BEACH",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "90277-5326",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "310-913-3969",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "25825 SOUTH VERMONT AVE.",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HARBOR CITY",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "90710",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "310-517-4060",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/26/2009",
"LastUpdateDate": "01/26/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "NINNESS-SEVERIOS",
"AuthorizedOfficialFirstName": "SARAH",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PHYSICAL THERAPIST",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.P.T.",
"AuthorizedOfficialTelephoneNumber": "310-913-3969",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "302R00000X",
"TaxonomyName": "Health Maintenance Organization",
"LicenseNumber": "35342",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "305R00000X",
"TaxonomyName": "Preferred Provider Organization",
"LicenseNumber": "35342",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}