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General NPI Number Information
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NPI Number | 1932621034
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Entity Type | Individual
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Provider Name | JOSEPH LATHAM PSY.D.
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Gender | Male
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Dates
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Enumeration Date | 07/10/2017
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Last Update Date | 05/07/2025
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Provider Practice Location Address
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Address Line | 27201 PUERTA REAL STE 300
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City | MISSION VIEJO
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State | CA
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Zip | 92691-8590
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Country | US
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Telephone | 949-592-6500
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Fax |
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Provider Business Mailing Address
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Address Line | 27201PUERTA REAL STE 300
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City | MISSION VIEJO
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State | CA
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Zip | 92691-7359
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Country | US
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Telephone | 949-592-6500
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Fax | 949-420-4501
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY.0006386
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 103TF0200X
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Taxonomy Name | Forensic Psychologist
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License Number | 35056
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 35056
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License Number State | CA
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