Healthcare Provider Details

I. General information

NPI: 1760353445
Provider Name (Legal Business Name): COREMIND PSYCHOLOGY, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2025
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1460 MARIA LN STE 300
WALNUT CREEK CA
94596-5314
US

IV. Provider business mailing address

1460 MARIA LANE, STE 300 #51059
WALNUT CREEK CA
94596
US

V. Phone/Fax

Practice location:
  • Phone: 925-236-0295
  • Fax:
Mailing address:
  • Phone: 925-236-0295
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: KAYLIN JONES
Title or Position: CEO
Credential: PHD
Phone: 925-236-0295