Johanna Alicia Latham

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95038240 Issued in CA

Practice address

1253 W I St
Los Banos, CA 93635-3930

Phone

(209) 710-6333

NPI assigned

Dec 13, 2007

Reactivated

Sep 21, 2026

Last updated

Oct 7, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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

{
    "created_epoch": "1197504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791331200000",
    "number": "1407039332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1253 W I ST",
            "city": "LOS BANOS",
            "state": "CA",
            "postal_code": "936353930",
            "telephone_number": "209-710-6333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1253 W I ST",
            "city": "LOS BANOS",
            "state": "CA",
            "postal_code": "936353930",
            "telephone_number": "209-710-6333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATHAM",
        "first_name": "JOHANNA",
        "middle_name": "ALICIA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-13",
        "last_updated": "2026-10-07",
        "certification_date": "2026-10-07",
        "deactivation_date": "2026-08-27",
        "reactivation_date": "2026-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95038240",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "755647",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pratap S Kurra, MD
• Lags Spine and Sportscare Medical Centers, Inc. (Lags Medical Center)
• Elisa Lara, CADC-CAS
• Marsha Ann Larson, RN
• Isabelle Lash
• LB Physical Therapy PC
• Brendan Lee, DDS
• Jun Lee
• Melisa Karam Lelham
• Jessie Lewis

• Family Nurse Practitioner in Los Banos, CA
• Providers in Los Banos, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.