{
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"FirstLineMailingAddress": "10808 FOOTHILL BLVD STE 160-725",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "RANCHO CUCAMONGA",
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"MailingAddressTelephoneNumber": "951-554-0904",
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"FirstLinePracticeLocationAddress": "10808 FOOTHILL BLVD STE 160-725",
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"PracticeLocationAddressCityName": "RANCHO CUCAMONGA",
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"PracticeLocationAddressTelephoneNumber": "909-731-3955",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "05/11/2020",
"LastUpdateDate": "05/20/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "EALEY",
"AuthorizedOfficialFirstName": "SHALBE",
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"AuthorizedOfficialTitle": "PRESIDENT",
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"AuthorizedOfficialCredential": "PSY.D.",
"AuthorizedOfficialTelephoneNumber": "909-554-0904",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Mental Health Clinic/Center (Including Community Mental Health Center)",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
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}
}