{
"Npi": {
"NPI": "1922326180",
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "INLAND EMPIRE JOB CORPS CENTER",
"LastName": null,
"FirstName": null,
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"NamePrefix": null,
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"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "3173 KERRY ST",
"SecondLineMailingAddress": "HEALTH & WELLNESS DEPARTMENT",
"MailingAddressCityName": "SAN BERNARDINO",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92407-6325",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "909-887-7105",
"MailingAddressFaxNumber": "909-473-1510",
"FirstLinePracticeLocationAddress": "3173 KERRY ST",
"SecondLinePracticeLocationAddress": "HEALTH & WELLNESS DEPARTMENT",
"PracticeLocationAddressCityName": "SAN BERNARDINO",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "92407-6325",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "909-887-7105",
"PracticeLocationAddressFaxNumber": "909-473-1510",
"EnumerationDate": "05/12/2010",
"LastUpdateDate": "05/12/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "STULL",
"AuthorizedOfficialFirstName": "LINDA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CENTER DIRECTOR",
"AuthorizedOfficialNamePrefix": "MS.",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "909-887-7146",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QS1000X",
"TaxonomyName": "Student Health Clinic/Center",
"LicenseNumber": "G53297",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}