1558570796 NPI number — GARY DANIEL HULL M.DIV., MSW, LCSW

NPI Number: 1558570796
Health Care Provider/Practitioner: GARY DANIEL HULL M.DIV., MSW, LCSW

NPI Number : 1558570796 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1558570796",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "HULL",
    "FirstName": "GARY",
    "MiddleName": "DANIEL",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "M.DIV., MSW, LCSW",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "2105 FOREST AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SAN JOSE",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "95128-1425",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "408-947-2607",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "22505 WOODROE AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "HAYWARD",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "94541-3410",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "510-537-2869",
    "PracticeLocationAddressFaxNumber": "510-537-9222",
    "EnumerationDate": "05/22/2007",
    "LastUpdateDate": "12/09/2022",
    "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": "101YM0800X",
          "TaxonomyName": "Mental Health Counselor",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YP1600X",
          "TaxonomyName": "Pastoral Counselor",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "1041C0700X",
          "TaxonomyName": "Clinical Social Worker",
          "LicenseNumber": "69465",
          "LicenseNumberStateCode": "CA",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}