NPI Code Detail JSON Logo

1619264132 NPI number — NEURODEVELOPMENTAL LEARNING INSTITUTE

NPI Number: 1619264132
Health Care Provider/Practitioner: NEURODEVELOPMENTAL LEARNING INSTITUTE

Information about “1619264132” NPI (NEURODEVELOPMENTAL LEARNING INSTITUTE) exists in 1619264132 in HTML format HTML  |  1619264132 in plain Text format TXT  |  1619264132 in PDF (Portable Document Format) PDF  |  1619264132 in an XML format XML  formats.

NPI Number : 1619264132 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1619264132",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "NEURODEVELOPMENTAL LEARNING INSTITUTE",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "12063 JEFFERSON BLVD # A",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CULVER CITY",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "90230-6219",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "310-821-3640",
    "MailingAddressFaxNumber": "310-526-3438",
    "FirstLinePracticeLocationAddress": "12063 JEFFERSON BLVD # A",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "CULVER CITY",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "90230-6219",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "310-821-3640",
    "PracticeLocationAddressFaxNumber": "310-526-3438",
    "EnumerationDate": "07/05/2011",
    "LastUpdateDate": "11/11/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "KAYEM",
    "AuthorizedOfficialFirstName": "ERIN",
    "AuthorizedOfficialMiddleName": "D",
    "AuthorizedOfficialTitle": "OWNER, EXECUTIVE DIRECTOR",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "M.S., CCC-SLP",
    "AuthorizedOfficialTelephoneNumber": "310-384-5159",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "106H00000X",
          "TaxonomyName": "Marriage & Family Therapist",
          "LicenseNumber": "18502",
          "LicenseNumberStateCode": "CA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "225X00000X",
          "TaxonomyName": "Occupational Therapist",
          "LicenseNumber": "11010",
          "LicenseNumberStateCode": "CA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "235Z00000X",
          "TaxonomyName": "Speech-Language Pathologist",
          "LicenseNumber": "10919",
          "LicenseNumberStateCode": "CA",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        }
      ]
    }
  }
}
                
            

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