{
"Npi": {
"NPI": "1891667424",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "GOLESTANI HOTKNY",
"FirstName": "BAHAREH",
"MiddleName": null,
"NamePrefix": "MS.",
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "EL FAHFOUHI",
"OtherFirstName": "ADNANE",
"OtherMiddleName": null,
"OtherNamePrefix": "MR.",
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "5",
"FirstLineMailingAddress": "21226 TRUMPET DR UNIT 205",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "NEWHALL",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "91321-4442",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "818-572-3934",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "21226 TRUMPET DR UNIT 205",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "NEWHALL",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "91321-4442",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "818-572-3934",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "09/22/2025",
"LastUpdateDate": "10/24/2025",
"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": "246RP1900X",
"TaxonomyName": "Phlebotomy Technician",
"LicenseNumber": "E8K9Y8K8",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "164X00000X",
"TaxonomyName": "Licensed Vocational Nurse",
"LicenseNumber": "280996",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}