{
"Npi": {
"NPI": "1952700320",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "CARRASCO-GONZALEZ",
"FirstName": "CYNTHIA",
"MiddleName": "CRYSTAL",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "F.N.P",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "CARRASCO-GONZALEZ",
"OtherFirstName": "CYNTHIA",
"OtherMiddleName": "CRYSTAL",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "RN",
"OtherLastNameTypeCode": "5",
"FirstLineMailingAddress": "1400 WEWATTA ST STE 350",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DENVER",
"MailingAddressStateName": "CO",
"MailingAddressPostalCode": "80202-5553",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "704-661-1380",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "9330 WASHINGTON BLVD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PICO RIVERA",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "90660-3838",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "704-661-1380",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "08/21/2014",
"LastUpdateDate": "04/23/2025",
"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": "363LF0000X",
"TaxonomyName": "Family Nurse Practitioner",
"LicenseNumber": "95013719",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "163W00000X",
"TaxonomyName": "Registered Nurse",
"LicenseNumber": "788748",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "2083P0500X",
"TaxonomyName": "Preventive Medicine/Occupational Environmental Medicine Physician",
"LicenseNumber": "95013719",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}