{
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"EIN": null,
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"OtherCredential": "PHD",
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"FirstLineMailingAddress": "328 GREAT MOUNTAIN DR",
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"MailingAddressCityName": "WEST COVINA",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "91791-2381",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "619-718-2526",
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"FirstLinePracticeLocationAddress": "1425 W FOOTHILL BLVD STE 310",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "UPLAND",
"PracticeLocationAddressStateName": "CA",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "877-527-7227",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "08/21/2013",
"LastUpdateDate": "10/08/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
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"AuthorizedOfficialCredential": null,
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Marriage & Family Therapist",
"LicenseNumber": "LMFT95741",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}