{
"Npi": {
"NPI": "1437651890",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "YANEZ",
"FirstName": "CHRISTINA",
"MiddleName": "MONIQUE",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "RBT",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "YANEZ",
"OtherFirstName": "CHRISTINA",
"OtherMiddleName": "MONIQUE",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "RBT",
"OtherLastNameTypeCode": "5",
"FirstLineMailingAddress": "1631 GLORIA DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "STOCKTON",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "95205-2694",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "209-561-0676",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "18051 N RAY RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LODI",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "95242-9309",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "916-420-3165",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "03/01/2018",
"LastUpdateDate": "03/17/2018",
"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": "106S00000X",
"TaxonomyName": "Behavior Technician",
"LicenseNumber": "106SOOOOOX",
"LicenseNumberStateCode": "CA",
"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."
}
}
}
}