{
"Npi": {
"NPI": "1881426476",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "LEWIS-UPTON",
"FirstName": "MARGARITA",
"MiddleName": "LUCAS",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "LEWIS",
"OtherFirstName": "MARGARITA",
"OtherMiddleName": "LUCAS",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "RN",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "5853 VENTANA DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "FONTANA",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92336-5615",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "909-641-0717",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "16854 IVY AVE STE A",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "FONTANA",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "92335-1504",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "909-791-1000",
"PracticeLocationAddressFaxNumber": "909-781-6000",
"EnumerationDate": "08/14/2024",
"LastUpdateDate": "06/10/2025",
"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": "363LG0600X",
"TaxonomyName": "Gerontology Nurse Practitioner",
"LicenseNumber": "95033971",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "163W00000X",
"TaxonomyName": "Registered Nurse",
"LicenseNumber": "774371",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}