{
"Npi": {
"NPI": "1437923463",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "AMI",
"ParentOrgTIN": null,
"OrgName": "AMI HEALTHCARE STAFFING",
"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": "14844 MARTELL AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SAN LEANDRO",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "94578-4417",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "510-461-3271",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "2950 INTERNATIONAL BLVD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "OAKLAND",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "94601-2228",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "510-535-4400",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "11/09/2023",
"LastUpdateDate": "11/09/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "AGUILAR",
"AuthorizedOfficialFirstName": "MANUEL",
"AuthorizedOfficialMiddleName": "ADOLFO",
"AuthorizedOfficialTitle": "DENTAL HYGIENIST",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RDH",
"AuthorizedOfficialTelephoneNumber": "510-461-3271",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "124Q00000X",
"TaxonomyName": "Dental Hygienist",
"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."
}
}
}
}