Healthcare Provider Details

I. General information

NPI: 1316631252
Provider Name (Legal Business Name): MINDCARE PSYCHOLOGICAL SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2023
Last Update Date: 06/05/2023
Certification Date: 06/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4900 CALIFORNIA AVE STE 210B
BAKERSFIELD CA
93309-7080
US

IV. Provider business mailing address

PO BOX 21474
BAKERSFIELD CA
93390-1474
US

V. Phone/Fax

Practice location:
  • Phone: 661-241-9515
  • Fax:
Mailing address:
  • Phone: 661-241-3515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DR. ANA MENA
Title or Position: CEO
Credential: PSYD
Phone: 661-241-3515