{
"Npi": {
"NPI": "1811017403",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "COYLE",
"FirstName": "VIRGINIA",
"MiddleName": null,
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "PSY.D.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "3711 LONG BEACH BLVD STE 4065",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LONG BEACH",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "90807-3315",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "562-685-3016",
"MailingAddressFaxNumber": "562-318-3081",
"FirstLinePracticeLocationAddress": "3711 LONG BEACH BLVD STE 4065",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LONG BEACH",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "90807-3315",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "562-685-3016",
"PracticeLocationAddressFaxNumber": "562-318-3081",
"EnumerationDate": "03/29/2007",
"LastUpdateDate": "11/12/2024",
"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": "103T00000X",
"TaxonomyName": "Psychologist",
"LicenseNumber": "27169",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}