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1760721856 NPI number — MWENDE MUALUKO PHD

NPI Number: 1760721856
Health Care Provider/Practitioner: MWENDE MUALUKO PHD

Information about “1760721856” NPI (MWENDE MUALUKO PHD) exists in 1760721856 in HTML format HTML  |  1760721856 in plain Text format TXT  |  1760721856 in PDF (Portable Document Format) PDF  |  1760721856 in an XML format XML  formats.

NPI Number : 1760721856 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1760721856",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MUALUKO",
    "FirstName": "MWENDE",
    "MiddleName": null,
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "PHD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "8305 GREENSBORO DR APT 910",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MC LEAN",
    "MailingAddressStateName": "VA",
    "MailingAddressPostalCode": "22102-7377",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "404-414-8600",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "8280 WILLOW OAKS CORPORATE DR STE 600",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "FAIRFAX",
    "PracticeLocationAddressStateName": "VA",
    "PracticeLocationAddressPostalCode": "22031-4516",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "703-634-4490",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "02/08/2013",
    "LastUpdateDate": "05/10/2024",
    "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": "103TC0700X",
          "TaxonomyName": "Clinical Psychologist",
          "LicenseNumber": "PSY-2167",
          "LicenseNumberStateCode": "HI",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "103TC0700X",
          "TaxonomyName": "Clinical Psychologist",
          "LicenseNumber": "9374624-2501",
          "LicenseNumberStateCode": "UT",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "103TC0700X",
          "TaxonomyName": "Clinical Psychologist",
          "LicenseNumber": "0810005824",
          "LicenseNumberStateCode": "VA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "103TC0700X",
          "TaxonomyName": "Clinical Psychologist",
          "LicenseNumber": "PY60278819",
          "LicenseNumberStateCode": "WA",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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