{
"Npi": {
"NPI": "1518051242",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "JANNISE",
"FirstName": "APRIL",
"MiddleName": "MICHELLE",
"NamePrefix": "MISS",
"NameSuffix": null,
"Credential": "LCSW",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "WEATHERFORD",
"OtherFirstName": "APRIL",
"OtherMiddleName": "MICHELLE",
"OtherNamePrefix": "MISS",
"OtherNameSuffix": null,
"OtherCredential": "BA",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "21342 AVENIDA MANANTIAL",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LAKE FOREST",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92630-2125",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "949-305-0687",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "400 W CIVIC CENTER DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SANTA ANA",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "92701-4539",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "714-347-0363",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "10/03/2006",
"LastUpdateDate": "11/09/2023",
"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": "1041C0700X",
"TaxonomyName": "Clinical Social Worker",
"LicenseNumber": "003304",
"LicenseNumberStateCode": "GA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "1041C0700X",
"TaxonomyName": "Clinical Social Worker",
"LicenseNumber": "24625",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}