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1477625572 NPI number — LINDA CAROL GORIN-SIBNER PH.D.

NPI Number: 1477625572
Health Care Provider/Practitioner: LINDA CAROL GORIN-SIBNER PH.D.

Information about “1477625572” NPI (LINDA CAROL GORIN-SIBNER PH.D.) exists in 1477625572 in HTML format HTML  |  1477625572 in plain Text format TXT  |  1477625572 in PDF (Portable Document Format) PDF  |  1477625572 in an XML format XML  formats.

NPI Number : 1477625572 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1477625572",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "GORIN-SIBNER",
    "FirstName": "LINDA",
    "MiddleName": "CAROL",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "PH.D.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "SIBNER",
    "OtherFirstName": "LINDA",
    "OtherMiddleName": "CAROL",
    "OtherNamePrefix": "DR.",
    "OtherNameSuffix": null,
    "OtherCredential": "PH.D.",
    "OtherLastNameTypeCode": "5",
    "FirstLineMailingAddress": "3709 VIA LA SELVA",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PALOS VERDES ESTATES",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "90274-1117",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "310-784-7170",
    "MailingAddressFaxNumber": "310-791-8656",
    "FirstLinePracticeLocationAddress": "4560 ADMIRALTY WAY",
    "SecondLinePracticeLocationAddress": "SUITE 302",
    "PracticeLocationAddressCityName": "MARINA DEL REY",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "90292-5423",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "310-784-7170",
    "PracticeLocationAddressFaxNumber": "310-791-8656",
    "EnumerationDate": "11/14/2006",
    "LastUpdateDate": "07/08/2007",
    "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": "103TC0700X",
        "TaxonomyName": "Clinical Psychologist",
        "LicenseNumber": "PSY10452",
        "LicenseNumberStateCode": "CA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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