{
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"FirstLineMailingAddress": "1910 WEST FARLINGTON",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WEST COVINA",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "91790",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "310-863-6199",
"MailingAddressFaxNumber": "888-789-9773",
"FirstLinePracticeLocationAddress": "757 RIDGESIDE DR",
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"PracticeLocationAddressCityName": "MONROVIA",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "213-260-0605",
"PracticeLocationAddressFaxNumber": "888-789-9773",
"EnumerationDate": "07/30/2015",
"LastUpdateDate": "09/12/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "FRANKLIN",
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"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QM0801X",
"TaxonomyName": "Mental Health Clinic/Center (Including Community Mental Health Center)",
"LicenseNumber": "PSY24447",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
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}
}