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1972420362 NPI number — MRS. LAUREN WITKOWSKI MATAMOROS

NPI Number: 1972420362
Health Care Provider/Practitioner: MRS. LAUREN WITKOWSKI MATAMOROS

Information about “1972420362” NPI (MRS. LAUREN WITKOWSKI MATAMOROS) exists in 1972420362 in HTML format HTML  |  1972420362 in plain Text format TXT  |  1972420362 in PDF (Portable Document Format) PDF  |  1972420362 in an XML format XML  formats.

NPI Number : 1972420362 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1972420362",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MATAMOROS",
    "FirstName": "LAUREN",
    "MiddleName": "WITKOWSKI",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "WITKOWSKI",
    "OtherFirstName": "LAUREN",
    "OtherMiddleName": "RACHAEL",
    "OtherNamePrefix": "MS.",
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "205 FOREST LN",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SAN BRUNO",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "94066-3127",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "725 WELCH RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PALO ALTO",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "94304-1601",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "985-515-4642",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "07/06/2026",
    "LastUpdateDate": "07/06/2026",
    "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": "95118054",
        "LicenseNumberStateCode": "CA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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