Dr. Amy E Latta
Clinical Neuropsychologist

Address: 1020 W Main St, 100-b, Boise, ID 83702-5789
Phone: 2082508939

Dr. Amy E Latta (NPI# 1750536264) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1750536264
Entity Type Individual
Full Name Dr. Amy E Latta
Credential PH.D.
Gender Female
Practice Address 1020 W Main St
100-b
Boise
ID 83702-5789
Practice Telephone 2082508939
Mailing Address 7154 W State St
106
Boise
ID 83714-7421
Mailing Telephone 2082508939
Sole Proprietor Yes, this individual is a Sole Proprietor
Enumeration Date 2008-11-25
Last Update Date 2009-06-16

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
Yes 103G00000X Clinical Neuropsychologist Behavioral Health & Social Service Providers PSY-202458 ID
No 103G00000X Clinical Neuropsychologist Behavioral Health & Social Service Providers PSY 22317 CA

Other Providers AMY LATTA

NPI Name Taxonomy Address Enumeration
1962495598 Amy M Latta Family Medicine 17110 Dallas Pkwy, #100, Dallas, TX 75248-1167 2005-08-30

Physician Overview

NPI 1750536264
PAC ID by PECOS 6406919422
Professional Enrollment ID I20090116000146
Full Name Amy E Latta
Organization Legal Name NORTHWEST NEUROBEHAVIORAL HEALTH LLC
Phone Number 2089557333
Gender F
Graduation Year 2006
Primary Specialty CLINICAL PSYCHOLOGIST
Group Practice PAC ID 0446432512
Number of Group Practice Members 11
Accepts Medicare Assignment Y

Office Location

Street Address 1020 W MAIN ST
100-B
City BOISE
State ID
Zip Code 83702-5789

Providers in the same location

NPI Name Taxonomy Address Enumeration
1265677298 Amy E. Latta, Ph.d., P.a. Clinical Neuropsychologist 1020 W Main St, Suite 100b, Boise, ID 83702-5789 2008-12-04

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NPI Name Taxonomy Address Enumeration
1508359084 Emily Cook Dietitian, Registered St. Luke's Rehab Hospital, 600 N Robbins Road, Bosie, ID 83702 2018-06-11
1265925887 Marla Braendle Dietitian, Registered St. Luke's Rehabilitation Hospital, 600 N. Robbins Road, Boise, ID 83702 2018-06-08
1114419678 Sidrah Khan Psychotherapy PC Social Worker 242 N 8th St, Suite 200, Boise, ID 83702 2018-05-31
1508386707 Emp Idaho Nampa, LLC General Acute Care Hospital 350 E Myrtle Street, Suite 100, Boise, ID 83702 2017-06-20
1194264077 Karen Mangum Dietitian, Registered 115 N. Main Street, Suite #203, Boise, ID 83702 2017-02-13
1750828422 Stephen Pyper Massage Therapist 14089 Main St #100, Boise, ID 83702 2017-01-19
1427504398 The Young Mens Christian Association of Boise City Idaho Health Educator 419 N 11th St, Boise, ID 83702 2016-08-30
1942756838 Brent Hiroshi Sasaki Pharmacist 500 West Fort Street (119), Boise, ID 83702 2016-08-30
1578912051 Marnae Walker Counselor 509 S. 14th St, Suite 2, Boise, ID 83702 2016-06-06
1205200821 Caitlin Trisler Pharmacist 1915 W State St, Boise, ID 83702 2015-11-19
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Taxonomy Information

Taxonomy Code 103G00000X
Grouping Behavioral Health & Social Service Providers
Classification Clinical Neuropsychologist

Taxonomy Definition

A clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems.
Notes: Source: American Psychological Association, www.apa.org [1/1/2007: title modified, 1/1/2019: defintion modified]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1790241404 Boise Brain Health Clinical Neuropsychologist 4696 W Overland Rd Ste 228, Boise, ID 83705-2864 2019-02-18
1295954485 Saint Alphonsus Regional Medical Center Inc Clinical Neuropsychologist 717 N Liberty St, Boise, ID 83704-9342 2007-04-25
1952443640 Christine Pickford Clinical Neuropsychologist 1104 N 18th St, Boise, ID 83702-3321 2007-02-12
1225176498 Craig W. Beaver Clinical Neuropsychologist 250 Bobwhite Ct Ste 220, Boise, ID 83706-3983 2007-02-01
1326008053 David E Nilsson Clinical Neuropsychologist 2537 W. State St., Suite 210, Boise, ID 83702 2006-03-25
1215305263 Cynthia Tremblay Clinical Neuropsychologist 600 N Robbins Rd, Boise, ID 83702-4565 2015-09-08
1154665123 Merry Sylvester Clinical Neuropsychologist 1055 N Curtis Rd, Boise, ID 83706-1309 2012-11-15
1659631562 Brienne M Dyer Clinical Neuropsychologist 500 W Fort St, (b114), Boise, ID 83702-4501 2012-05-24
1275891194 David E. Nilsson, Ph.d., P.C. Clinical Neuropsychologist 950 W Bannock St Ste 1100, Boise, ID 83702-6140 2012-04-28
1316241417 Jeff Alan Sordahl Jr. Clinical Neuropsychologist 500 W Fort St, Boise, ID 83702-4501 2011-01-04
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City BOISE
Zip Code 83702

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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