Active NPI
Melissa Dawn Latham, PHD
- Clinical Psychologist
- Auburn, CA
National Provider Identifier
1164114773
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 32928
- Practice address
- 11985 Heritage Oak PL
Auburn, CA 95603-2413 - Phone
- (530) 889-4925
- NPI assigned
- May 23, 2023
- Last updated
- Jun 19, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cognitive & Behavioral Psychologist | 103TB0200X | 32928 | CA | |
| Clinical Psychologist | 103TC0700X | 32928 | CA | Primary |
Addresses
Primary practice location
11985 Heritage Oak PL
Auburn, CA 95603-2413
Mailing address
11985 Heritage Oak PL
Auburn, CA 95603-2413
Phone (530) 889-4925
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 32928 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718755200000",
"number": "1164114773",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11985 HERITAGE OAK PL",
"city": "AUBURN",
"state": "CA",
"postal_code": "956032413",
"telephone_number": "530-889-4925"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11985 HERITAGE OAK PL",
"city": "AUBURN",
"state": "CA",
"postal_code": "956032413",
"telephone_number": "530-889-4925"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LATHAM",
"first_name": "MELISSA",
"middle_name": "DAWN",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-05-23",
"last_updated": "2024-06-19",
"certification_date": "2024-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "CA",
"license": "32928",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "32928",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Auburn, CA
- Brian Scott Larsen, DC
- Patricia Larson, MA, MFTI
- Savannah Larson
- Steven Craig Larson, DC
- Mark William Lashley, ADDICTION SPECIALIST
- Nicole Renee Laubach Ferretti, LCSW
- Laura Faudree, Licensed Marriage & Family Therapist, Inc
- Jodi Lynn Lavoie, MSW
- Mary Lavoie, AUDIOLOGIST/SP.PATH.
- Steve Lavoie, HEARING AID DISPENSE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.