NPI Code Detail JSON Logo

1396531919 NPI number — THERAPY ROOM, ISAI SERRANO, LICENSED CLINICAL SOCIAL WORKER, PROFESSIONAL CORP

NPI Number: 1396531919
Health Care Provider/Practitioner: THERAPY ROOM, ISAI SERRANO, LICENSED CLINICAL SOCIAL WORKER, PROFESSIONAL CORP

Information about “1396531919” NPI (THERAPY ROOM, ISAI SERRANO, LICENSED CLINICAL SOCIAL WORKER, PROFESSIONAL CORP) exists in 1396531919 in HTML format HTML  |  1396531919 in plain Text format TXT  |  1396531919 in PDF (Portable Document Format) PDF  |  1396531919 in an XML format XML  formats.

NPI Number : 1396531919 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1396531919",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "THERAPY ROOM, ISAI SERRANO, LICENSED CLINICAL SOCIAL WORKER, PROFESSIONAL CORP",
    "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": "927 S BRUCE ST APT 8",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ANAHEIM",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "92804-1113",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "657-791-6082",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "79505 CAMELBACK DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BERMUDA DUNES",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "92203-1485",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "657-791-6082",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "04/18/2025",
    "LastUpdateDate": "04/18/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "SERRANO",
    "AuthorizedOfficialFirstName": "ISAI",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "CEO",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "LCSW",
    "AuthorizedOfficialTelephoneNumber": "760-391-7108",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "1041C0700X",
        "TaxonomyName": "Clinical Social Worker",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193400000X 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."
      }
    }
  }
}
                
            

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