{
"Npi": {
"NPI": "1639711450",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "MENDOZA",
"FirstName": "ALEXANDRA",
"MiddleName": "ROUELLE",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "NP-C",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "MENDOZA",
"OtherFirstName": "ROUELLE",
"OtherMiddleName": "PARAYNO",
"OtherNamePrefix": "MS.",
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "5128 EDERIA WAY",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BAKERSFIELD",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "93313",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "661-865-9963",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "3941 SAN DIMAS ST STE 101",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BAKERSFIELD",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "93301-5711",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "661-864-7944",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "10/14/2019",
"LastUpdateDate": "01/30/2020",
"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": "363LF0000X",
"TaxonomyName": "Family Nurse Practitioner",
"LicenseNumber": "95013055",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}