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1740936210 NPI number — ISABELA FORTES BAUMGARDNER FDN-P, CIYT, CYT

NPI Number: 1740936210
Health Care Provider/Practitioner: ISABELA FORTES BAUMGARDNER FDN-P, CIYT, CYT

Information about “1740936210” NPI (ISABELA FORTES BAUMGARDNER FDN-P, CIYT, CYT) exists in 1740936210 in HTML format HTML  |  1740936210 in plain Text format TXT  |  1740936210 in PDF (Portable Document Format) PDF  |  1740936210 in an XML format XML  formats.

NPI Number : 1740936210 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1740936210",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BAUMGARDNER",
    "FirstName": "ISABELA",
    "MiddleName": "FORTES",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "FDN-P, CIYT, CYT",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "FORTES",
    "OtherFirstName": "ISABELA",
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "FDN-P, CIYT, CYT",
    "OtherLastNameTypeCode": "2",
    "FirstLineMailingAddress": "18 CORTE EL BRAZO",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SAN CLEMENTE",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "92673-7023",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "949-547-9673",
    "MailingAddressFaxNumber": "949-481-5282",
    "FirstLinePracticeLocationAddress": "18 CORTE EL BRAZO # 18",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SAN CLEMENTE",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "92673-7023",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "949-547-9673",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "02/23/2022",
    "LastUpdateDate": "02/23/2022",
    "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": "171400000X",
        "TaxonomyName": "Health & Wellness Coach",
        "LicenseNumber": "225143908",
        "LicenseNumberStateCode": "TX",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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