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1932854213 NPI number — RONA BALICAS DIVINAGRACIA APRN, PMHNP-BC, CCM

NPI Number: 1932854213
Health Care Provider/Practitioner: RONA BALICAS DIVINAGRACIA APRN, PMHNP-BC, CCM

Information about “1932854213” NPI (RONA BALICAS DIVINAGRACIA APRN, PMHNP-BC, CCM) exists in 1932854213 in HTML format HTML  |  1932854213 in plain Text format TXT  |  1932854213 in PDF (Portable Document Format) PDF  |  1932854213 in an XML format XML  formats.

NPI Number : 1932854213 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1932854213",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "DIVINAGRACIA",
    "FirstName": "RONA",
    "MiddleName": "BALICAS",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "APRN, PMHNP-BC, CCM",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "BALICAS",
    "OtherFirstName": "RONA",
    "OtherMiddleName": "S",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "1400 POTTERY AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PORT ORCHARD",
    "MailingAddressStateName": "WA",
    "MailingAddressPostalCode": "98366-3768",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "360-895-5000",
    "MailingAddressFaxNumber": "877-516-9023",
    "FirstLinePracticeLocationAddress": "1400 POTTERY AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PORT ORCHARD",
    "PracticeLocationAddressStateName": "WA",
    "PracticeLocationAddressPostalCode": "98366-3711",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "360-895-5000",
    "PracticeLocationAddressFaxNumber": "360-782-1701",
    "EnumerationDate": "02/15/2022",
    "LastUpdateDate": "08/24/2026",
    "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": "163W00000X",
          "TaxonomyName": "Registered Nurse",
          "LicenseNumber": "RN85093",
          "LicenseNumberStateCode": "NV",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LP0808X",
          "TaxonomyName": "Psychiatric/Mental Health Nurse Practitioner",
          "LicenseNumber": "867980",
          "LicenseNumberStateCode": "NV",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LP0808X",
          "TaxonomyName": "Psychiatric/Mental Health Nurse Practitioner",
          "LicenseNumber": "AP61575192",
          "LicenseNumberStateCode": "WA",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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