{
"Npi": {
"NPI": "1851512131",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "MANN",
"FirstName": "SUZANNE",
"MiddleName": "BETTE",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "PHD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "MANN",
"OtherFirstName": "SUZANNE",
"OtherMiddleName": "LANDRES",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "PHD",
"OtherLastNameTypeCode": "2",
"FirstLineMailingAddress": "3205 SONOMA ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "TORRANCE",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "90503",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "310-320-9307",
"MailingAddressFaxNumber": "310-320-9307",
"FirstLinePracticeLocationAddress": "23545 CRENSHAW BLVD",
"SecondLinePracticeLocationAddress": "#101B",
"PracticeLocationAddressCityName": "TORRANCE",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "90505",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "310-320-9307",
"PracticeLocationAddressFaxNumber": "310-320-9307",
"EnumerationDate": "05/02/2007",
"LastUpdateDate": "07/09/2007",
"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": "103TC0700X",
"TaxonomyName": "Clinical Psychologist",
"LicenseNumber": "PSY12091",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}