NPI Code Detail JSON Logo

1679723407 NPI number — AUDREY LAMAR OWENS MSPT

NPI Number: 1679723407
Health Care Provider/Practitioner: AUDREY LAMAR OWENS MSPT

Information about “1679723407” NPI (AUDREY LAMAR OWENS MSPT) exists in 1679723407 in HTML format HTML  |  1679723407 in plain Text format TXT  |  1679723407 in PDF (Portable Document Format) PDF  |  1679723407 in an XML format XML  formats.

NPI Number : 1679723407 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1679723407",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "OWENS",
    "FirstName": "AUDREY",
    "MiddleName": "LAMAR",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MSPT",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "18 FAIRMOUNT ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SAN FRANCISCO",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "94131-2768",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "415-225-2406",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "100 S SAN MATEO DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SAN MATEO",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "94401-3805",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "650-696-4012",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "09/29/2008",
    "LastUpdateDate": "09/29/2008",
    "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": "2251N0400X",
        "TaxonomyName": "Neurology Physical Therapist",
        "LicenseNumber": "28998-PT",
        "LicenseNumberStateCode": "CA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2025 Data Labs Health. All rights reserved.