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1396050787 NPI number — ANA-LISA I.E. BARTELT MA, MFT

NPI Number: 1396050787
Health Care Provider/Practitioner: ANA-LISA I.E. BARTELT MA, MFT

Information about “1396050787” NPI (ANA-LISA I.E. BARTELT MA, MFT) exists in 1396050787 in HTML format HTML  |  1396050787 in plain Text format TXT  |  1396050787 in PDF (Portable Document Format) PDF  |  1396050787 in an XML format XML  formats.

NPI Number : 1396050787 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1396050787",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BARTELT",
    "FirstName": "ANA-LISA",
    "MiddleName": "I.E.",
    "NamePrefix": "MS.",
    "NameSuffix": null,
    "Credential": "MA, MFT",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "BARTELT",
    "OtherFirstName": "ANNA",
    "OtherMiddleName": null,
    "OtherNamePrefix": "MS.",
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "3775 WILD OATS LN",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BONITA",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "91902-3059",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "808-741-1019",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "855 BOWSPRIT RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "CHULA VISTA",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "91914-4529",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "808-535-7600",
    "PracticeLocationAddressFaxNumber": "808-535-7630",
    "EnumerationDate": "08/10/2010",
    "LastUpdateDate": "07/14/2020",
    "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": "101YM0800X",
          "TaxonomyName": "Mental Health Counselor",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "106H00000X",
          "TaxonomyName": "Marriage & Family Therapist",
          "LicenseNumber": "104664",
          "LicenseNumberStateCode": "CA",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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