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1790794105 NPI number — NICOLE SUMMER MCCUISTION MFT

NPI Number: 1790794105
Health Care Provider/Practitioner: NICOLE SUMMER MCCUISTION MFT

Information about “1790794105” NPI (NICOLE SUMMER MCCUISTION MFT) exists in 1790794105 in HTML format HTML  |  1790794105 in plain Text format TXT  |  1790794105 in PDF (Portable Document Format) PDF  |  1790794105 in an XML format XML  formats.

NPI Number : 1790794105 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1790794105",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MCCUISTION",
    "FirstName": "NICOLE",
    "MiddleName": "SUMMER",
    "NamePrefix": "MS.",
    "NameSuffix": null,
    "Credential": "MFT",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "131 W MIDWAY DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ANAHEIM",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "92805-6507",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "714-717-3711",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "131 W MIDWAY DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ANAHEIM",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "92805-6507",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "714-517-7107",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "08/05/2006",
    "LastUpdateDate": "11/23/2010",
    "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": "106H00000X",
        "TaxonomyName": "Marriage & Family Therapist",
        "LicenseNumber": "MFC42478",
        "LicenseNumberStateCode": "CA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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