{
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"FirstLineMailingAddress": "1312 ALMA AVE APT 1",
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"MailingAddressCityName": "MODESTO",
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"FirstLinePracticeLocationAddress": "3800 DALE RD",
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"PracticeLocationAddressCityName": "MODESTO",
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"EnumerationDate": "05/24/2014",
"LastUpdateDate": "02/11/2022",
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"NPIReactivationDate": null,
"GenderCode": "F",
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"Taxonomies": {
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}