{
"Npi": {
"NPI": "1619867975",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "SANDOVAL",
"FirstName": "CHELSEA",
"MiddleName": "BROOKE",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "BSN, RN, CCRN, NAR",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "WIEDENFELD",
"OtherFirstName": "CHELSEA",
"OtherMiddleName": "BROOKE",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "BSN, RN, CCRN",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "3235 N ROVA CT",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "VISALIA",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "93291-8244",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "210-620-4868",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "20 E RIVER PARK PL W",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "FRESNO",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "93720-1551",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "559-256-4950",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "07/08/2025",
"LastUpdateDate": "07/08/2025",
"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": "163W00000X",
"TaxonomyName": "Registered Nurse",
"LicenseNumber": "959095",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "163W00000X",
"TaxonomyName": "Registered Nurse",
"LicenseNumber": "95306327",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}