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1639400344 NPI number — MS. YOLANDA ARCIAGA BUDOMO

NPI Number: 1639400344
Health Care Provider/Practitioner: MS. YOLANDA ARCIAGA BUDOMO

Information about “1639400344” NPI (MS. YOLANDA ARCIAGA BUDOMO) exists in 1639400344 in HTML format HTML  |  1639400344 in plain Text format TXT  |  1639400344 in PDF (Portable Document Format) PDF  |  1639400344 in an XML format XML  formats.

NPI Number : 1639400344 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1639400344",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BUDOMO",
    "FirstName": "YOLANDA",
    "MiddleName": "ARCIAGA",
    "NamePrefix": "MS.",
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "BUDOMO-FOWLER",
    "OtherFirstName": "YOLANDA",
    "OtherMiddleName": "ARCIAGA",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "RPH",
    "OtherLastNameTypeCode": "5",
    "FirstLineMailingAddress": "3487 STOCKTON HILL RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "KINGMAN",
    "MailingAddressStateName": "AZ",
    "MailingAddressPostalCode": "86409-3681",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "928-692-1822",
    "MailingAddressFaxNumber": "928-692-6404",
    "FirstLinePracticeLocationAddress": "2116 ROY ROGERS WAY",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "KINGMAN",
    "PracticeLocationAddressStateName": "AZ",
    "PracticeLocationAddressPostalCode": "86409-0945",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "928-692-4743",
    "PracticeLocationAddressFaxNumber": "928-692-6404",
    "EnumerationDate": "01/20/2010",
    "LastUpdateDate": "01/20/2010",
    "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": "183500000X",
        "TaxonomyName": "Pharmacist",
        "LicenseNumber": "S015308",
        "LicenseNumberStateCode": "AZ",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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