NPI Code Detail JSON Logo

1841583010 NPI number — SAMANTHA HUESTIS PHD

NPI Number: 1841583010
Health Care Provider/Practitioner: SAMANTHA HUESTIS PHD

Information about “1841583010” NPI (SAMANTHA HUESTIS PHD) exists in 1841583010 in HTML format HTML  |  1841583010 in plain Text format TXT  |  1841583010 in PDF (Portable Document Format) PDF  |  1841583010 in an XML format XML  formats.

NPI Number : 1841583010 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1841583010",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "HUESTIS",
    "FirstName": "SAMANTHA",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "PHD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "321 MIDDLEFIELD RD",
    "SecondLineMailingAddress": "PEDIATRIC PAIN MANAGEMENT, SUITE 225",
    "MailingAddressCityName": "MENLO PARK",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "94025-3500",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "725 WELCH RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PALO ALTO",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "94304-1601",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "650-497-8000",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/22/2011",
    "LastUpdateDate": "04/11/2024",
    "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": "103TC2200X",
          "TaxonomyName": "Clinical Child & Adolescent Psychologist",
          "LicenseNumber": "PSY25493",
          "LicenseNumberStateCode": "CA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207LP2900X",
          "TaxonomyName": "Pain Medicine (Anesthesiology) Physician",
          "LicenseNumber": "PSY25493",
          "LicenseNumberStateCode": "CA",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.