{
"Npi": {
"NPI": "1609504224",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "GOLAN",
"FirstName": "DANIEL",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "MA, LMFT",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "GOLAN",
"OtherFirstName": "DANIELLE",
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "MA, LMFT",
"OtherLastNameTypeCode": "2",
"FirstLineMailingAddress": "1501 LINCOLN BLVD # 1101",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "VENICE",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "90291-3503",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "424-274-0518",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1990 N CALIFORNIA BLVD STE 20 PMB 1036",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WALNUT CREEK",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "94596",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "424-274-0518",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "08/11/2022",
"LastUpdateDate": "08/11/2022",
"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": "134068",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}