{
"Npi": {
"NPI": "1649939208",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "THEBUS",
"FirstName": "KARIN",
"MiddleName": null,
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "PSYD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "THEBUS",
"OtherFirstName": "KARIN",
"OtherMiddleName": null,
"OtherNamePrefix": "DR.",
"OtherNameSuffix": null,
"OtherCredential": "PSYD",
"OtherLastNameTypeCode": "2",
"FirstLineMailingAddress": "PO BOX 7147",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "RANCHO SANTA FE",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92067-7147",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1337 CAMINO DEL MAR STE B",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "DEL MAR",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "92014-2504",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "858-733-1814",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "12/10/2021",
"LastUpdateDate": "12/10/2021",
"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": "103T00000X",
"TaxonomyName": "Psychologist",
"LicenseNumber": "33050",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}