1831385616 NPI number — VERONICA RUBY ORELLANA M.A., MFT INTERN

NPI Number: 1831385616
Health Care Provider/Practitioner: VERONICA RUBY ORELLANA M.A., MFT INTERN

NPI Number : 1831385616 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1831385616",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "ORELLANA",
    "FirstName": "VERONICA",
    "MiddleName": "RUBY",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "M.A., MFT INTERN",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "CARDENAS",
    "OtherFirstName": "VERONICA",
    "OtherMiddleName": "RUBY",
    "OtherNamePrefix": "MS.",
    "OtherNameSuffix": null,
    "OtherCredential": "M.A., MFT-INTERN",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "9280 BIRCH ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "RANCHO CUCAMONGA",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "91730-2501",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "323-983-3270",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1000 CORPORATE CENTER DR STE 650",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MONTEREY PARK",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "91754",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "626-957-8442",
    "PracticeLocationAddressFaxNumber": "626-266-5780",
    "EnumerationDate": "09/14/2007",
    "LastUpdateDate": "09/05/2018",
    "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": "IMF 54874",
          "LicenseNumberStateCode": "CA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "106H00000X",
          "TaxonomyName": "Marriage & Family Therapist",
          "LicenseNumber": "IMF76653",
          "LicenseNumberStateCode": "CA",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}