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1780246975 NPI number — MERCY MARIA FAUSTO MA. LMFT

NPI Number: 1780246975
Health Care Provider/Practitioner: MERCY MARIA FAUSTO MA. LMFT

Information about “1780246975” NPI (MERCY MARIA FAUSTO MA. LMFT) exists in 1780246975 in HTML format HTML  |  1780246975 in plain Text format TXT  |  1780246975 in PDF (Portable Document Format) PDF  |  1780246975 in an XML format XML  formats.

NPI Number : 1780246975 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1780246975",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "FAUSTO",
    "FirstName": "MERCY",
    "MiddleName": "MARIA",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "MA. LMFT",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "SOMERA",
    "OtherFirstName": "MERCY",
    "OtherMiddleName": "MARIA",
    "OtherNamePrefix": "MS.",
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "1545 SAINT MARKS PLZ STE 5",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "STOCKTON",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "95207-6411",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "209-290-5771",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1545 SAINT MARKS PLZ STE 5",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "STOCKTON",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "95207-6411",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "209-471-2617",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "07/08/2019",
    "LastUpdateDate": "04/18/2024",
    "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": "101YP2500X",
        "TaxonomyName": "Professional Counselor",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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