{
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"FirstLineMailingAddress": "5700 N WINTHROP AVE APT 6",
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"FirstLinePracticeLocationAddress": "110 GOUGH ST STE 203",
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"PracticeLocationAddressCityName": "SAN FRANCISCO",
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"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "02/24/2022",
"LastUpdateDate": "03/06/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": "04/12/2022",
"NPIReactivationDate": "11/22/2022",
"GenderCode": "F",
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"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "106H00000X",
"TaxonomyName": "Marriage & Family Therapist",
"LicenseNumber": "LMFT150992",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}