{
"Npi": {
"NPI": "1871281949",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "GRANADOS-LAYOSO",
"FirstName": "SAMANTHA",
"MiddleName": "KATRINA",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "FNP-BC",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "GRANADOS",
"OtherFirstName": "SAMANTHA",
"OtherMiddleName": "KATRINA",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "FNP-BC",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "4934 RIDGEFIELD CIR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "FAIRFIELD",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "94534-6432",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "818-658-0570",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "2160 JEFFERSON ST STE 260",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "NAPA",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "94559-1252",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "72-590-7007",
"PracticeLocationAddressFaxNumber": "707-252-2645",
"EnumerationDate": "04/26/2023",
"LastUpdateDate": "01/15/2024",
"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": "363LF0000X",
"TaxonomyName": "Family Nurse Practitioner",
"LicenseNumber": "95024918",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}