{
"Npi": {
"NPI": "1720188790",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "RUSSELL",
"FirstName": "KATHRYN",
"MiddleName": "JANE",
"NamePrefix": "MS.",
"NameSuffix": null,
"Credential": "MFT",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "RUSSELL-GRAFIUS",
"OtherFirstName": "KATHRYN",
"OtherMiddleName": "JANE",
"OtherNamePrefix": "MS.",
"OtherNameSuffix": null,
"OtherCredential": "MFT",
"OtherLastNameTypeCode": "5",
"FirstLineMailingAddress": "24721 SPRING RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "COLTON",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92324-9635",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "909-423-0860",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "5029 LAMART DR",
"SecondLinePracticeLocationAddress": "#6",
"PracticeLocationAddressCityName": "RIVERSIDE",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "92507-0605",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "951-369-9800",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "09/22/2006",
"LastUpdateDate": "07/08/2007",
"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": "106H00000X",
"TaxonomyName": "Marriage & Family Therapist",
"LicenseNumber": "MX1557",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}