Individual provider Active NPI

Megan Kay Higinbotham, PH.D.

  • Clinical Child & Adolescent Psychologist
  • Torrance, CA
National Provider Identifier
1003398868
Registry record updated Jan 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
Practice address
25550 Hawthorne Blvd Ste 316
Torrance, CA 90505-6832
Phone
(424) 757-4344
NPI assigned
Aug 29, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X Primary

Addresses

Primary practice location

25550 Hawthorne Blvd Ste 316
Torrance, CA 90505-6832

Mailing address

25550 Hawthorne Blvd Ste 316
Torrance, CA 90505-6832
Phone (424) 757-4344

Other practice location 1

40 Camelot Dr
Fond Du Lac, WI 54935-8049
Phone (920) 907-8201

Other practice location 2

801 Campus Dr
Fond Du Lac, WI 54935-1600
Phone (920) 929-2740

Other practice location 3

430 E Division St
Fond Du Lac, WI 54935-4597
Phone (920) 929-2300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
South Bay Family Counseling Corp. Clinical Child & Adolescent CurrentSince Jul 4, 2021 Accepting new patients

Locations

25550 Hawthorne Blvd
Ste 316
Torrance, CA 90505
Phone (310) 686-4867

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1535500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610582400000",
    "number": "1003398868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25550 HAWTHORNE BLVD STE 316",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905056832",
            "telephone_number": "424-757-4344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25550 HAWTHORNE BLVD STE 316",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905056832",
            "telephone_number": "424-757-4344"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "40 Camelot Dr",
            "address_purpose": "LOCATION",
            "city": "Fond Du Lac",
            "state": "WI",
            "postal_code": "549358049",
            "country_code": "US",
            "telephone_number": "920-907-8201",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "801 Campus Dr",
            "address_purpose": "LOCATION",
            "city": "Fond Du Lac",
            "state": "WI",
            "postal_code": "549351600",
            "country_code": "US",
            "telephone_number": "920-929-2740",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "430 E Division St",
            "address_purpose": "LOCATION",
            "city": "Fond Du Lac",
            "state": "WI",
            "postal_code": "549354597",
            "country_code": "US",
            "telephone_number": "920-929-2300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HIGINBOTHAM",
        "first_name": "MEGAN",
        "middle_name": "KAY",
        "name_prefix": "Mrs.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-29",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.