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1477159846 NPI number — FRANCISCO DANIEL BRIZUELA BS, LPT, NCPT3, CCMA

NPI Number: 1477159846
Health Care Provider/Practitioner: FRANCISCO DANIEL BRIZUELA BS, LPT, NCPT3, CCMA

Information about “1477159846” NPI (FRANCISCO DANIEL BRIZUELA BS, LPT, NCPT3, CCMA) exists in 1477159846 in HTML format HTML  |  1477159846 in plain Text format TXT  |  1477159846 in PDF (Portable Document Format) PDF  |  1477159846 in an XML format XML  formats.

NPI Number : 1477159846 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1477159846",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BRIZUELA",
    "FirstName": "FRANCISCO",
    "MiddleName": "DANIEL",
    "NamePrefix": "MR.",
    "NameSuffix": null,
    "Credential": "BS, LPT, NCPT3, CCMA",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "BRIZUELA",
    "OtherFirstName": "DANIEL",
    "OtherMiddleName": null,
    "OtherNamePrefix": "MR.",
    "OtherNameSuffix": null,
    "OtherCredential": "NCPT3, CCMA",
    "OtherLastNameTypeCode": "5",
    "FirstLineMailingAddress": "2019 S VAN NESS AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SANTA ANA",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "92707-2639",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "714-371-5777",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "2019 S VAN NESS AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SANTA ANA",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "92707-2639",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "714-317-3573",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "12/09/2020",
    "LastUpdateDate": "06/24/2022",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "225C00000X",
        "TaxonomyName": "Rehabilitation Counselor",
        "LicenseNumber": "20-CMHRS-00017",
        "LicenseNumberStateCode": "CA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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