{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "ASIAN AMERICANS FOR COMMUNITY INVOLVEMENT",
"LastName": null,
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"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherCredential": null,
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"FirstLineMailingAddress": "1975 ADELE PL",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SAN JOSE",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "95125-4651",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "408-806-9141",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "2400 MOORPARK AVE",
"SecondLinePracticeLocationAddress": "SUITE 300",
"PracticeLocationAddressCityName": "SAN JOSE",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "95128-2631",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "408-975-2730",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "11/06/2014",
"LastUpdateDate": "11/06/2014",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WONG",
"AuthorizedOfficialFirstName": "JORGE",
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"AuthorizedOfficialTitle": "DIRECTOR OF CLINICAL AND REGULATORY",
"AuthorizedOfficialNamePrefix": "DR.",
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"AuthorizedOfficialCredential": "PSYCHOLOGIST",
"AuthorizedOfficialTelephoneNumber": "408-975-2730",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "302R00000X",
"TaxonomyName": "Health Maintenance Organization",
"LicenseNumber": "18253",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}