{
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"MailingAddressTelephoneNumber": "925-915-6188",
"MailingAddressFaxNumber": "925-800-7755",
"FirstLinePracticeLocationAddress": "1320 WILLOW PASS RD STE 643",
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"EnumerationDate": "03/08/2025",
"LastUpdateDate": "03/08/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "VALLEGA",
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"AuthorizedOfficialCredential": "RN",
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"Taxonomies": {
"Taxonomy": {
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}