Johnny Ray Latham, is a
Community Health Worker based in Apple Valley, California. Johnny Ray Latham is licensed to practice in * (Not Available) (license number ) and his current practice location is
17800 Us Highway 18, Apple Valley, California. He can be reached at his office (for appointments etc.) via phone at
(760) 946-8200.
NPI number for Johnny Ray Latham is 1598149080 and his current mailing address is 17800 Us Highway 18, Apple Valley, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1598149080.
Healthcare Provider's Profile
| Full Name | Johnny Ray Latham |
|---|
| Gender | Male |
|---|
| Speciality | Community Health Worker |
|---|
| Location | 17800 Us Highway 18, Apple Valley, California |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1598149080
- Provider Enumeration Date: 07/14/2015
- Last Update Date: 09/24/2024
Medical Identifiers
Medical identifiers for Johnny Ray Latham such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1598149080 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | 10386 (California) | Secondary |
| 172V00000X | Community Health Worker | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Johnny Ray Latham is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Johnny Ray Latham,
17800 Us Highway 18,
Apple Valley, CA 92307-1221
Ph: (760) 946-8200 | Johnny Ray Latham,
17800 Us Highway 18,
Apple Valley, CA 92307-1221
Ph: (760) 946-8200 |
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