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1780292136 NPI number — MS. CASLEA JOY SERINA

NPI Number: 1780292136
Health Care Provider/Practitioner: MS. CASLEA JOY SERINA

Information about “1780292136” NPI (MS. CASLEA JOY SERINA) exists in 1780292136 in HTML format HTML  |  1780292136 in plain Text format TXT  |  1780292136 in PDF (Portable Document Format) PDF  |  1780292136 in an XML format XML  formats.

NPI Number : 1780292136 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1780292136",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "SERINA",
    "FirstName": "CASLEA",
    "MiddleName": "JOY",
    "NamePrefix": "MS.",
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "3875 GEIST RD STE 402",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "FAIRBANKS",
    "MailingAddressStateName": "AK",
    "MailingAddressPostalCode": "99709-3564",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "907-450-9962",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "544 4TH AVE STE 102",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "FAIRBANKS",
    "PracticeLocationAddressStateName": "AK",
    "PracticeLocationAddressPostalCode": "99701-4714",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "907-450-9962",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "07/21/2020",
    "LastUpdateDate": "11/14/2023",
    "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": "225700000X",
          "TaxonomyName": "Massage Therapist",
          "LicenseNumber": "2183165",
          "LicenseNumberStateCode": "AK",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "225700000X",
          "TaxonomyName": "Massage Therapist",
          "LicenseNumber": "150512",
          "LicenseNumberStateCode": "AK",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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