{
"Npi": {
"NPI": "1548316722",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "RUIZ",
"FirstName": "ELLEN",
"MiddleName": "VARVITSIOTES",
"NamePrefix": "MS.",
"NameSuffix": null,
"Credential": "M.F.T.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1134 DELAWARE ST",
"SecondLineMailingAddress": "SUITE D",
"MailingAddressCityName": "BERKELEY",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "94702-1672",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "510-524-2398",
"MailingAddressFaxNumber": "510-288-1337",
"FirstLinePracticeLocationAddress": "1026 OAK GROVE RD",
"SecondLinePracticeLocationAddress": "SUITE 11",
"PracticeLocationAddressCityName": "CONCORD",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "94518-3289",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "925-646-5459",
"PracticeLocationAddressFaxNumber": "915-646-5102",
"EnumerationDate": "01/28/2007",
"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": "106H00000X",
"TaxonomyName": "Marriage & Family Therapist",
"LicenseNumber": "MFC 42350",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}