{
"Npi": {
"NPI": "1811310691",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "CENTER FOR JAPANESE MENTAL HEALTH",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1910 HUNTINGTON DR UNIT 10",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SOUTH PASADENA",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "91030-4887",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "626-831-9322",
"MailingAddressFaxNumber": "626-831-9379",
"FirstLinePracticeLocationAddress": "1910 HUNTINGTON DR UNIT 10",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SOUTH PASADENA",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "91030-4887",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "626-831-9322",
"PracticeLocationAddressFaxNumber": "626-831-9379",
"EnumerationDate": "01/29/2014",
"LastUpdateDate": "06/10/2021",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "YU",
"AuthorizedOfficialFirstName": "CHI",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OPERATIONS MANAGER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "626-831-9322",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251V00000X",
"TaxonomyName": "Voluntary or Charitable Agency",
"LicenseNumber": "3632073",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}