{
"Npi": {
"NPI": "1790555860",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "ELIGIO",
"FirstName": "AUBREY MARIE",
"MiddleName": "RAZALAN",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "FNP-C",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "RAZALAN",
"OtherFirstName": "AUBREY MARIE SHALIMA",
"OtherMiddleName": "DULAY",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "7155 CITRUS AVE UNIT 128",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "FONTANA",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92336-6002",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "818-272-2984",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1701 E CESAR E CHAVEZ AVE STE 128",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LOS ANGELES",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "90033-2483",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "323-223-2338",
"PracticeLocationAddressFaxNumber": "323-225-2340",
"EnumerationDate": "01/08/2024",
"LastUpdateDate": "01/08/2024",
"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": "363LF0000X",
"TaxonomyName": "Family Nurse Practitioner",
"LicenseNumber": "95025095",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}