Mara Gwynne Latts, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY18222 Issued in CA

Practice address

13193 Central Ave
Suite 200
Chino, CA 91710-7200

Phone

(909) 902-9111

Fax

(909) 902-9199

NPI assigned

Nov 18, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Foothills Psychological Services IncGroup PAC ID 9436157534, 37 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Foothills Psychological Services, Inc.

  • Psychologist
  • Upland, CA
  • NPI 1336121888
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215919865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13193 CENTRAL AVE",
            "address_2": "SUITE 200",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917107200",
            "telephone_number": "909-902-9111",
            "fax_number": "909-902-9199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13193 CENTRAL AVE",
            "address_2": "SUITE 200",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917107200",
            "telephone_number": "909-902-9111",
            "fax_number": "909-902-9199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATTS",
        "first_name": "MARA",
        "middle_name": "GWYNNE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY18222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul Pao-Chien Lai, D.O.
• James M Lally, D.O.
• Melanie Guadalupe Lambourg, LM, CPM
• Jesse Tabisula Lamog, DPT
• Marcelino Dellopac Latina, DO
• Teresa Layman, M.S. CCC-SLP
• Le Faith, LTD
• Le-Asis Optometry, Inc.
• Doananh Le
• Kielson T Le, DPM

• Clinical Psychologist in Chino, CA
• Providers in Chino, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.