{
"Npi": {
"NPI": "1962600403",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "PATEL",
"FirstName": "PAYAL",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "OT",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "MEHTA",
"OtherFirstName": "PAYAL",
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "OT",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "6840 E KALLIN WAY",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LONG BEACH",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "90815-5006",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "410-570-0934",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "17122 BEACH BLVD STE 101",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HUNTINGTON BEACH",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "92647-5992",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "714-848-7191",
"PracticeLocationAddressFaxNumber": "714-375-7563",
"EnumerationDate": "07/05/2007",
"LastUpdateDate": "06/11/2019",
"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": "225X00000X",
"TaxonomyName": "Occupational Therapist",
"LicenseNumber": "9084",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}