{
"Npi": {
"NPI": "1629311469",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "WASHINGTON",
"FirstName": "HEATHER",
"MiddleName": "OLIVIA",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "M.D.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "BELCHER",
"OtherFirstName": "HEATHER",
"OtherMiddleName": "OLIVIA",
"OtherNamePrefix": "DR.",
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "711 W 2ND ST STE A",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SAN BERNARDINO",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92410-3262",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "888-854-1397",
"MailingAddressFaxNumber": "714-709-4974",
"FirstLinePracticeLocationAddress": "5379 HAMNER AVE UNIT 801",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "EASTVALE",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "91752-1042",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "888-854-1397",
"PracticeLocationAddressFaxNumber": "714-709-4684",
"EnumerationDate": "03/29/2013",
"LastUpdateDate": "02/12/2025",
"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": "207Q00000X",
"TaxonomyName": "Family Medicine Physician",
"LicenseNumber": "A135435",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}