Organization Active NPI

Seahorse Psychology Center Corp

  • Clinical Psychologist
  • Sacramento, CA
National Provider Identifier
1730934027
Registry record updated Jun 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
SEAHORSE PSYCHOLOGY CENTER CORP
Practice address
1401 21St Street
Ste R
Sacramento, CA 95811
Phone
(949) 291-0038
NPI assigned
Apr 19, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2024

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

Authorized official

Name
Joseph Latham, PSY.D.NPI 1932621034
Title
Clinical Psychologist
Phone
(901) 830-8746

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

1401 21St Street
Ste R
Sacramento, CA 95811

Mailing address

3943 Irvine Blvd # 1026
Irvine, CA 92602-2400
Phone (949) 291-0038

Other practice location 1

448 S McCulloch Blvd # 1052
Pueblo West, CO 81007-2888
Phone (949) 592-6500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250908001722 CA Part B Supplier - Clinic/Group Practice 8527560622 Receives reassigned benefits from 1 practitioner
Practice locations: Mission Viejo, CA

National Provider Directory

National Provider Directory

Locations

448 S McCulloch Blvd
Pueblo West, CO 81007
Phone (719) 696-1160

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1713484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717632000000",
    "number": "1730934027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3943 IRVINE BLVD # 1026",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926022400",
            "telephone_number": "949-291-0038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 21ST STREET",
            "address_2": "STE R",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95811",
            "telephone_number": "949-291-0038"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "448 S McCulloch Blvd # 1052",
            "address_purpose": "LOCATION",
            "city": "Pueblo West",
            "state": "CO",
            "postal_code": "810072888",
            "country_code": "US",
            "telephone_number": "949-592-6500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SEAHORSE PSYCHOLOGY CENTER CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-19",
        "last_updated": "2024-06-06",
        "certification_date": "2024-05-15",
        "status": "A",
        "authorized_official_last_name": "LATHAM",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "901-830-8746",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.