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1700461134 NPI number — ALISA ARIELLE CARSTENS

NPI Number: 1700461134
Health Care Provider/Practitioner: ALISA ARIELLE CARSTENS

Information about “1700461134” NPI (ALISA ARIELLE CARSTENS) exists in 1700461134 in HTML format HTML  |  1700461134 in plain Text format TXT  |  1700461134 in PDF (Portable Document Format) PDF  |  1700461134 in an XML format XML  formats.

NPI Number : 1700461134 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1700461134",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "CARSTENS",
    "FirstName": "ALISA",
    "MiddleName": "ARIELLE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "525 CABRILLO PARK DR STE 300",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SANTA ANA",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "92701-5017",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "714-953-4455",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "3551 CAMINO MIRA COSTA STE T",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SAN CLEMENTE",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "92672-3508",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "949-272-4444",
    "PracticeLocationAddressFaxNumber": "949-272-4445",
    "EnumerationDate": "03/17/2021",
    "LastUpdateDate": "03/25/2021",
    "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": "101YM0800X",
        "TaxonomyName": "Mental Health Counselor",
        "LicenseNumber": "9146",
        "LicenseNumberStateCode": "CA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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