NPI Code Detail JSON Logo

1962819789 NPI number — PSYCHIATRIC WELLNESS CENTER INC

NPI Number: 1962819789
Health Care Provider/Practitioner: PSYCHIATRIC WELLNESS CENTER INC

Information about “1962819789” NPI (PSYCHIATRIC WELLNESS CENTER INC) exists in 1962819789 in HTML format HTML  |  1962819789 in plain Text format TXT  |  1962819789 in PDF (Portable Document Format) PDF  |  1962819789 in an XML format XML  formats.

NPI Number : 1962819789 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1962819789",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "PSYCHIATRIC WELLNESS CENTER INC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "30300 AGOURA ROAD",
    "SecondLineMailingAddress": "SUITE 195",
    "MailingAddressCityName": "AGOURA HILLS",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "91301-5412",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "818-532-7950",
    "MailingAddressFaxNumber": "818-532-7685",
    "FirstLinePracticeLocationAddress": "30300 AGOURA ROAD",
    "SecondLinePracticeLocationAddress": "SUITE 195",
    "PracticeLocationAddressCityName": "AGOURA HILLS",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "91301-5412",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "818-532-7950",
    "PracticeLocationAddressFaxNumber": "818-532-7685",
    "EnumerationDate": "07/14/2014",
    "LastUpdateDate": "07/14/2014",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "CRUZ",
    "AuthorizedOfficialFirstName": "ELSA",
    "AuthorizedOfficialMiddleName": "CALUMPIT",
    "AuthorizedOfficialTitle": "OWNER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "M.D",
    "AuthorizedOfficialTelephoneNumber": "818-795-2515",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "103TC0700X",
          "TaxonomyName": "Clinical Psychologist",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "2084P0800X",
          "TaxonomyName": "Psychiatry Physician",
          "LicenseNumber": "A75757",
          "LicenseNumberStateCode": "CA",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        }
      ]
    }
  }
}
                
            

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