{
"Npi": {
"NPI": "1811790991",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "BEERS",
"FirstName": "ALLYSA",
"MiddleName": "WILSON",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "TRS, CTRS",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "WILSON",
"OtherFirstName": "ALLYSA",
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "TRS, CTRS",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "5500 MING AVE STE 265",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BAKERSFIELD",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "93309-4696",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "228 W 400 N",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SARATOGA SPRINGS",
"PracticeLocationAddressStateName": "UT",
"PracticeLocationAddressPostalCode": "84045-3102",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "385-715-4410",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/01/2025",
"LastUpdateDate": "04/01/2025",
"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": "225800000X",
"TaxonomyName": "Recreation Therapist",
"LicenseNumber": "6875400-4002",
"LicenseNumberStateCode": "UT",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}