Healthcare Provider Details

I. General information

NPI: 1023948767
Provider Name (Legal Business Name): INSIGHTFUL MINDS HEALING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

162 SENTINEL DR S
MADERA CA
93636-8981
US

IV. Provider business mailing address

162 SENTINEL DR S
MADERA CA
93636-8981
US

V. Phone/Fax

Practice location:
  • Phone: 559-330-1776
  • Fax:
Mailing address:
  • Phone: 559-330-1776
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: JENNIE LOPEZ
Title or Position: LMFT
Credential: LMFT
Phone: 559-375-9871