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1417780966 NPI number — REBECCA KARIN HENSON

NPI Number: 1417780966
Health Care Provider/Practitioner: REBECCA KARIN HENSON

Information about “1417780966” NPI (REBECCA KARIN HENSON) exists in 1417780966 in HTML format HTML  |  1417780966 in plain Text format TXT  |  1417780966 in PDF (Portable Document Format) PDF  |  1417780966 in an XML format XML  formats.

NPI Number : 1417780966 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1417780966",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "HENSON",
    "FirstName": "REBECCA",
    "MiddleName": "KARIN",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "BARRERA",
    "OtherFirstName": "REBECCA",
    "OtherMiddleName": "KARIN",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "415 N CRESCENT DR STE 340",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BEVERLY HILLS",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "90210-4884",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "562-382-4763",
    "MailingAddressFaxNumber": "310-388-5809",
    "FirstLinePracticeLocationAddress": "415 N CRESCENT DR STE 340",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BEVERLY HILLS",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "90210-4884",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "562-382-4763",
    "PracticeLocationAddressFaxNumber": "310-388-5809",
    "EnumerationDate": "08/21/2024",
    "LastUpdateDate": "08/21/2024",
    "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": "363L00000X",
          "TaxonomyName": "Nurse Practitioner",
          "LicenseNumber": "F07241388",
          "LicenseNumberStateCode": "CA",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "163W00000X",
          "TaxonomyName": "Registered Nurse",
          "LicenseNumber": "95110213",
          "LicenseNumberStateCode": "CA",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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