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1518091982 NPI number — DR. CANDELARIO LARRY RESENDEZ II

NPI Number: 1518091982
Health Care Provider/Practitioner: DR. CANDELARIO LARRY RESENDEZ II

Information about “1518091982” NPI (DR. CANDELARIO LARRY RESENDEZ II) exists in 1518091982 in HTML format HTML  |  1518091982 in plain Text format TXT  |  1518091982 in PDF (Portable Document Format) PDF  |  1518091982 in an XML format XML  formats.

NPI Number : 1518091982 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1518091982",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "RESENDEZ",
    "FirstName": "CANDELARIO",
    "MiddleName": "LARRY",
    "NamePrefix": "DR.",
    "NameSuffix": "II",
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "25538 VIA PACIFICA",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "VALENCIA",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "91355-2650",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "661-286-2562",
    "MailingAddressFaxNumber": "661-222-7709",
    "FirstLinePracticeLocationAddress": "23502 LYONS AVE STE 304",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "NEWHALL",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "91321-2538",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "661-286-2562",
    "PracticeLocationAddressFaxNumber": "661-222-7709",
    "EnumerationDate": "03/15/2007",
    "LastUpdateDate": "07/08/2007",
    "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": "103TC0700X",
        "TaxonomyName": "Clinical Psychologist",
        "LicenseNumber": "PSY 17289",
        "LicenseNumberStateCode": "CA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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