{
"Npi": {
"NPI": "1841794955",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "KATAOKA",
"FirstName": "STACY",
"MiddleName": "ISAYE",
"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": "4892 SAN PABLO DAM RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "EL SOBRANTE",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "94803-3222",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "925-464-3340",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "4892 SAN PABLO DAM RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "EL SOBRANTE",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "94803-3222",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "510-836-9567",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "03/22/2018",
"LastUpdateDate": "08/25/2025",
"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": "103K00000X",
"TaxonomyName": "Behavior Analyst",
"LicenseNumber": "18-47937",
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "373H00000X",
"TaxonomyName": "Day Training/Habilitation Specialist",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}