1699920306 NPI number — YVONNE SUSANNE VENGER L.C.S.W.

NPI Number: 1699920306
Health Care Provider/Practitioner: YVONNE SUSANNE VENGER L.C.S.W.

NPI Number : 1699920306 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1699920306",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "VENGER",
    "FirstName": "YVONNE",
    "MiddleName": "SUSANNE",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "L.C.S.W.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "P.O.B. 1992",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "LA JOLLA",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "92038",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "858-404-0838",
    "MailingAddressFaxNumber": "619-260-8455",
    "FirstLinePracticeLocationAddress": "4550 KEARNY VILLA ROAD",
    "SecondLinePracticeLocationAddress": "SUITE 116",
    "PracticeLocationAddressCityName": "SAN DIEGO",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "92123",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "858-279-1223",
    "PracticeLocationAddressFaxNumber": "619-516-4757",
    "EnumerationDate": "11/21/2008",
    "LastUpdateDate": "11/21/2008",
    "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": "1041C0700X",
        "TaxonomyName": "Clinical Social Worker",
        "LicenseNumber": "24797",
        "LicenseNumberStateCode": "CA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}