Individual provider Active NPI

Joseph Latham, PSY.D.

  • Clinical Psychologist
  • Mission Viejo, CA
National Provider Identifier
1932621034
Registry record updated May 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
35056 Issued in CA
Practice address
27201 Puerta Real Ste 300
Mission Viejo, CA 92691-8590
Phone
(949) 592-6500
NPI assigned
Jul 10, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY.0006386 CO
Forensic Psychologist 103TF0200X 35056 CA
Student in an Organized Health Care Education/Training Program 390200000X
Clinical Psychologist 103TC0700X 35056 CA Primary

Addresses

Primary practice location

27201 Puerta Real Ste 300
Mission Viejo, CA 92691-8590

Mailing address

27201Puerta Real
Ste 300
Mission Viejo, CA 92691-7359
Phone (949) 592-6500

Other practice location 1

448 S McCulloch Blvd # 1052
Pueblo West, CO 81007-2888
Phone (949) 291-0038

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250910001471 CA Practitioner - Clinical Psychologist 2163924267 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

27201 Puerta Real
Suite 300
Mission Viejo, CA 92691-8590
Phone (949) 291-0038

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY.0006386COMDClinical Psychologist
35056CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Seahorse Psychology Center Corp Clinical CurrentSince Jul 1, 2025 Accepting new patients

Locations

3943 Irvine Blvd
Irvine, CA 92602
Phone (714) 922-0120

27201 Puerta Real
Ste 300
Mission Viejo, CA 92691
Phone (714) 552-1317

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

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1499644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746576000000",
    "number": "1932621034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27201PUERTA REAL",
            "address_2": "STE 300",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926917359",
            "telephone_number": "949-592-6500",
            "fax_number": "949-420-4501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27201 PUERTA REAL STE 300",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926918590",
            "telephone_number": "949-592-6500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "448 S McCulloch Blvd # 1052",
            "address_purpose": "LOCATION",
            "city": "Pueblo West",
            "state": "CO",
            "postal_code": "810072888",
            "country_code": "US",
            "telephone_number": "949-291-0038",
            "fax_number": "719-888-1756",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LATHAM",
        "first_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-07-10",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "PSY.0006386",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "CA",
            "license": "35056",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "35056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission Viejo, CA

Sources for this page

Verify at the official NPI Registry.