{
  "npi": "1073112157",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_credential": "LCSW",
    "authorized_official_first_name": "RONNIE",
    "authorized_official_last_name": "FERNANDEZ",
    "authorized_official_telephone_number": "3237933595",
    "authorized_official_title_or_position": "Executive Director",
    "certification_date": "2022-12-05",
    "enumeration_date": "2020-10-20",
    "last_updated": "2022-12-05",
    "organization_name": "10-20 CLUB INC.",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "10810 PARAMOUNT BLVD STE 202",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "DOWNEY",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "902413351",
      "state": "CA",
      "telephone_number": "562-294-3315"
    },
    {
      "address_1": "10810 PARAMOUNT BLVD STE 202",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "DOWNEY",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "902413351",
      "state": "CA",
      "telephone_number": "562-294-3315"
    }
  ],
  "taxonomies": [
    {
      "code": "101YM0800X",
      "desc": "Counselor, Mental Health",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": "193200000X - Multi-Specialty Group"
    },
    {
      "code": "261QM0855X",
      "desc": "Clinic/Center, Adolescent and Children Mental Health",
      "license": null,
      "primary": true,
      "state": null,
      "taxonomy_group": ""
    }
  ],
  "compliance": {
    "oig_leie_exclusion": {
      "excluded": false,
      "status": "CLEAR",
      "matches": [],
      "totalDbRecords": 84224
    },
    "cms_pecos_eligibility": {
      "note": "Not listed in CMS Order & Referring PECOS file or institutional NPI-2"
    }
  },
  "medicare_utilization": null,
  "enrichment": {
    "plain_english_specialty": "Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center",
    "certifying_board": "Accreditation Association for Ambulatory Health Care (AAAHC) / CMS",
    "cms_medicare_crosswalk": []
  }
}