{
"Npi": {
"NPI": "1831590942",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SOCAL CHILD THERAPY",
"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": "PO BOX 931774",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LOS ANGELES",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "90093-1774",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "917-517-7347",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "5195 LINDLEY AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "TARZANA",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "91356-4349",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "818-804-0322",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "09/08/2014",
"LastUpdateDate": "09/08/2014",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "JONES",
"AuthorizedOfficialFirstName": "GISELLE",
"AuthorizedOfficialMiddleName": "LOUISE",
"AuthorizedOfficialTitle": "THERAPIST",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "ASW",
"AuthorizedOfficialTelephoneNumber": "917-517-7347",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251S00000X",
"TaxonomyName": "Community/Behavioral Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}