{
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"EIN": null,
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"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "SCOTT",
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"FirstLineMailingAddress": "3099 VERMONT DR",
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"MailingAddressCityName": "CORONA",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92881-8313",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "951-454-5632",
"MailingAddressFaxNumber": "951-736-9672",
"FirstLinePracticeLocationAddress": "3595 UNIVERSITY AVE STE E",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "RIVERSIDE",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "92501-3343",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "951-454-5632",
"PracticeLocationAddressFaxNumber": "951-736-9672",
"EnumerationDate": "11/05/2006",
"LastUpdateDate": "07/08/2007",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "106H00000X",
"TaxonomyName": "Marriage & Family Therapist",
"LicenseNumber": "MFT 40147",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}