Nicholas Herkimer Putnam, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

G27562 Issued in CA

Practice address

4401 Manchester Ave
Suite #101
Encinitas, CA 92024-4938

Phone

(760) 753-4564

Fax

(760) 753-1541

NPI assigned

Jan 12, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1124178900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 MANCHESTER AVE",
            "address_2": "SUITE #101",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920244938",
            "telephone_number": "760-753-4564",
            "fax_number": "760-753-1541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 MANCHESTER AVE",
            "address_2": "SUITE #101",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920244938",
            "telephone_number": "760-753-4564",
            "fax_number": "760-753-1541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUTNAM",
        "first_name": "NICHOLAS",
        "middle_name": "HERKIMER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-12",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G27562",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "G27562",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G0027562",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Encinitas, CA
• Providers in Encinitas, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.