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1669640785 NPI number — ANGELA BALDWIN RUSHER PT, DPT

NPI Number: 1669640785
Health Care Provider/Practitioner: ANGELA BALDWIN RUSHER PT, DPT

Information about “1669640785” NPI (ANGELA BALDWIN RUSHER PT, DPT) exists in 1669640785 in HTML format HTML  |  1669640785 in plain Text format TXT  |  1669640785 in PDF (Portable Document Format) PDF  |  1669640785 in an XML format XML  formats.

NPI Number : 1669640785 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1669640785",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "RUSHER",
    "FirstName": "ANGELA",
    "MiddleName": "BALDWIN",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "PT, DPT",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "BALDWIN",
    "OtherFirstName": "ANGELA",
    "OtherMiddleName": "MARIE",
    "OtherNamePrefix": "DR.",
    "OtherNameSuffix": null,
    "OtherCredential": "PT, DPT",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "1076 CAROL LN",
    "SecondLineMailingAddress": "APT. #104",
    "MailingAddressCityName": "LAFAYETTE",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "94549-4757",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "805-452-3402",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "15400 FOOTHILL BLVD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SAN LEANDRO",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "94578-1009",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "510-895-4515",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "02/11/2008",
    "LastUpdateDate": "06/06/2012",
    "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": "225100000X",
        "TaxonomyName": "Physical Therapist",
        "LicenseNumber": "34258",
        "LicenseNumberStateCode": "CA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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