{
"Npi": {
"NPI": "1588121271",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "RASMUSSEN",
"FirstName": "JOSHUA",
"MiddleName": null,
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "DPT",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "31921 MAGPIE ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "TRABUCO CANYON",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92679-3481",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "215 N STATE COLLEGE BLVD STE G",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ANAHEIM",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "92806-2932",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "714-999-6596",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "02/28/2019",
"LastUpdateDate": "12/12/2023",
"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": "225100000X",
"TaxonomyName": "Physical Therapist",
"LicenseNumber": "296297",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}