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1538471974 NPI number — MELISSA ANN CERECERES RN, LMFT-A

NPI Number: 1538471974
Health Care Provider/Practitioner: MELISSA ANN CERECERES RN, LMFT-A

Information about “1538471974” NPI (MELISSA ANN CERECERES RN, LMFT-A) exists in 1538471974 in HTML format HTML  |  1538471974 in plain Text format TXT  |  1538471974 in PDF (Portable Document Format) PDF  |  1538471974 in an XML format XML  formats.

NPI Number : 1538471974 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1538471974",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "CERECERES",
    "FirstName": "MELISSA",
    "MiddleName": "ANN",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "RN, LMFT-A",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "BRANDOW",
    "OtherFirstName": "MELISSA",
    "OtherMiddleName": "ANN",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "PO BOX 685202",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "AUSTIN",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "78768-5202",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "512-773-6164",
    "MailingAddressFaxNumber": "512-519-4232",
    "FirstLinePracticeLocationAddress": "4534 W GATE BLVD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "AUSTIN",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "78745-1485",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "512-773-6164",
    "PracticeLocationAddressFaxNumber": "512-519-4232",
    "EnumerationDate": "07/13/2010",
    "LastUpdateDate": "07/13/2010",
    "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": "106H00000X",
          "TaxonomyName": "Marriage & Family Therapist",
          "LicenseNumber": "201578",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "163W00000X",
          "TaxonomyName": "Registered Nurse",
          "LicenseNumber": "781480",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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