{
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"IsOrgSubpart": "N",
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"OrgName": "GILBERT MARRIAGE AND FAMILY COUNSELING SERVICES, A PROFESSIONAL CORP.",
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"NamePrefix": null,
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"FirstLineMailingAddress": "7668 EL CAMINO REAL # 104-155",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CARLSBAD",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92009-7932",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "760-420-8845",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "43460 RIDGE PARK DR STE 200-C",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "TEMECULA",
"PracticeLocationAddressStateName": "CA",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "951-297-9111",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "11/10/2017",
"LastUpdateDate": "05/25/2019",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GILBERT",
"AuthorizedOfficialFirstName": "SHARI",
"AuthorizedOfficialMiddleName": "ANGELE",
"AuthorizedOfficialTitle": "VICE PRESIDENT / THERAPIST",
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"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LMFT",
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"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "106H00000X",
"TaxonomyName": "Marriage & Family Therapist",
"LicenseNumber": "50225",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}