{
"Npi": {
"NPI": "1689870008",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PRINCESSA INTEGRATIVE MEDICAL ASSOCIATES",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "18520 VIA PRINCESSA",
"SecondLineMailingAddress": "SUITE C-2",
"MailingAddressCityName": "CANYON COUNTRY",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "91387-8326",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "661-424-0900",
"MailingAddressFaxNumber": "661-424-0924",
"FirstLinePracticeLocationAddress": "18520 VIA PRINCESSA",
"SecondLinePracticeLocationAddress": "SUITE C-2",
"PracticeLocationAddressCityName": "CANYON COUNTRY",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "91387-8326",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "661-424-0900",
"PracticeLocationAddressFaxNumber": "661-424-0924",
"EnumerationDate": "06/22/2007",
"LastUpdateDate": "09/11/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "FELDMAN",
"AuthorizedOfficialFirstName": "ROCHELLE",
"AuthorizedOfficialMiddleName": "C",
"AuthorizedOfficialTitle": "MEDICAL DIRECTOR",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "661-424-0900",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "111NX0100X",
"TaxonomyName": "Occupational Health Chiropractor",
"LicenseNumber": "DC27810",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "208000000X",
"TaxonomyName": "Pediatrics Physician",
"LicenseNumber": "G32408",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "207R00000X",
"TaxonomyName": "Internal Medicine Physician",
"LicenseNumber": "A84167",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": [
{
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
},
{
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
},
{
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
]
}
}
}