{"npi":"1194032227","type":"NPI-1","status":"active","name":{"display":"Victoria Takubo PA-C","other":[{"code":"1","type":"Formerly known as","value":"MULLINS, VICTORIA LEIGH"}],"first":"VICTORIA","last":"TAKUBO","middle":"LEIGH","credential":"PA-C"},"specialty":{"primary_taxonomy":"363AS0400X","primary_taxonomy_description":"Surgical Physician Assistant","slug":"surgical-physician-assistant","schema_org_specialty":null,"all":[{"code":"363AM0700X","description":"Medical Physician Assistant","primary":false,"state":"WV","license":"01484"},{"code":"363AS0400X","description":"Surgical Physician Assistant","primary":true,"state":"WV","license":"1484"}]},"addresses":[{"purpose":"LOCATION","street_1":"4610 KANAWHA AVE SW STE 401","city":"SOUTH CHARLESTON","state":"WV","postal_code":"253091367","country_code":"US","phone":"3047687368","fax":"3047681829"},{"purpose":"MAILING","street_1":"4605 MACCORKLE AVE SW","city":"SOUTH CHARLESTON","state":"WV","postal_code":"253091311","country_code":"US","phone":"3044144800","fax":"3044144801"}],"license":{"state":"WV","number":"1484"},"identifiers":[],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20101116000612","type_code":"14-97","type_desc":"PRACTITIONER - PHYSICIAN ASSISTANT","state":"WV","pac_id":"9537354584"}]},"enumeration_date":"2010-09-10","last_updated":"2022-01-04","_meta":{"source":"NPPES","snapshot_date":"2022-01-04","doc_url":"https://findmynpi.com/api"}}