{
"Npi": {
"NPI": "1649785403",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "SCHWARTZ",
"FirstName": "KIMBERLEY",
"MiddleName": "R. ARGUE",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "PHD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "ARGUE",
"OtherFirstName": "KIMBERLEY",
"OtherMiddleName": null,
"OtherNamePrefix": "DR.",
"OtherNameSuffix": null,
"OtherCredential": "PHD",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "717 ROSARITA DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "FULLERTON",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92835-1842",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "714-553-7287",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "250 W MAIN ST STE 201",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "TUSTIN",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "92780-7718",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "714-553-7287",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "12/02/2017",
"LastUpdateDate": "06/16/2018",
"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": "103TC2200X",
"TaxonomyName": "Clinical Child & Adolescent Psychologist",
"LicenseNumber": "PSY17081",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "103TM1800X",
"TaxonomyName": "Intellectual & Developmental Disabilities Psychologist",
"LicenseNumber": "PSY17081",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "103TP0814X",
"TaxonomyName": "Psychoanalysis Psychologist",
"LicenseNumber": "PSY17081",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "103TC0700X",
"TaxonomyName": "Clinical Psychologist",
"LicenseNumber": "PSY17081",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}