Active NPI
Sree Datla
- Psychiatry Physician
- Colton, CA
National Provider Identifier
1023704319
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- A197257
- Practice address
- 400 N Pepper Ave
Colton, CA 92324-1819 - Phone
- (909) 580-1000
- NPI assigned
- Apr 11, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | A197257 | CA | Primary |
Addresses
Primary practice location
400 N Pepper Ave
Colton, CA 92324-1819
Mailing address
23141 Verdugo Dr Ste 201
Laguna Hills, CA 92653-1341
Other practice location 1
3669 7th Ave
Los Angeles, CA 90018-4107
Phone (424) 532-1552
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250709004347 | CA | Practitioner - Psychiatry | 3779097845 | Practice locations: Laguna Hills, CA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A197257 | CA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1681171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1762214400000",
"number": "1023704319",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23141 VERDUGO DR STE 201",
"city": "LAGUNA HILLS",
"state": "CA",
"postal_code": "926531341"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 N PEPPER AVE",
"city": "COLTON",
"state": "CA",
"postal_code": "923241819",
"telephone_number": "909-580-1000"
}
],
"practiceLocations": [
{
"address_1": "3669 7th Ave",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900184107",
"country_code": "US",
"telephone_number": "424-532-1552",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DATLA",
"first_name": "SREE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-04-11",
"last_updated": "2025-11-04",
"certification_date": "2025-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "A197257",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.