Latasha Marie Green McCullouch

Primary specialty

Health & Wellness CoachTaxonomy code 171400000X

Practice address

2500 W Orangethorpe Ave Ste 116
Fullerton, CA 92833-4237

Phone

(714) 353-2970

NPI assigned

Jul 15, 2024

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1721001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1700623931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 W ORANGETHORPE AVE STE 116",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928334237",
            "telephone_number": "714-353-2970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 W ORANGETHORPE AVE STE 116",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928334237",
            "telephone_number": "714-353-2970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLOUCH",
        "first_name": "LATASHA",
        "middle_name": "MARIE GREEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-15",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nikole Donelon McCoy, BCBA
• Robert Emmitt McCoy, M.D.
• William McCoy
• Ellie Kristine McCready
• Elizabeth Anne McCreary, MS, CCC-SLP
• Michele L McCutcheon
• Savannah McDermott
• Kamaile McDonald-Eckman
• Mary S McDonald
• Scott William McDonald II

• Health & Wellness Coach in Fullerton, CA
• Providers in Fullerton, CA by specialty
• Health & Wellness Coach in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 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.

Verify at the official NPI Registry.