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1528863917 NPI number — SHARELLE REGINA CRUZ CMPSS, HHP, LMT.

NPI Number: 1528863917
Health Care Provider/Practitioner: SHARELLE REGINA CRUZ CMPSS, HHP, LMT.

Information about “1528863917” NPI (SHARELLE REGINA CRUZ CMPSS, HHP, LMT.) exists in 1528863917 in HTML format HTML  |  1528863917 in plain Text format TXT  |  1528863917 in PDF (Portable Document Format) PDF  |  1528863917 in an XML format XML  formats.

NPI Number : 1528863917 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1528863917",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "CRUZ",
    "FirstName": "SHARELLE",
    "MiddleName": "REGINA",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "CMPSS, HHP, LMT.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "JACKSON",
    "OtherFirstName": "SHARELLE",
    "OtherMiddleName": "REGINA",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "CMPSS, HHP, LMT.",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "550 W WASHINGTON AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ESCONDIDO",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "92025-1643",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "10717 CAMINO RUIZ STE 134",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SAN DIEGO",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "92126-2362",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "858-465-0665",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "02/18/2025",
    "LastUpdateDate": "02/18/2025",
    "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": "225700000X",
        "TaxonomyName": "Massage Therapist",
        "LicenseNumber": "92163",
        "LicenseNumberStateCode": "CA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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