{
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"FirstLineMailingAddress": "20703 IBEX AVE",
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"MailingAddressFaxNumber": "562-278-2084",
"FirstLinePracticeLocationAddress": "710 N EUCLID ST",
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"PracticeLocationAddressCityName": "ANAHEIM",
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"EnumerationDate": "11/22/2019",
"LastUpdateDate": "11/22/2019",
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
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"AuthorizedOfficialLastName": "AGUILAR",
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"AuthorizedOfficialCredential": "NP",
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"Taxonomies": {
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"TaxonomyName": "Adult Health Nurse Practitioner",
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}