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General NPI Number Information
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NPI Number | 1528856036
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Entity Type | Organization
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Legal Business Name | SUMMIT MENTAL WELLNESS: A PSYCHOLOGICAL CORPORATION
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Dates
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Enumeration Date | 04/26/2025
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Last Update Date | 08/06/2025
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Provider Practice Location Address
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Address Line | 516 W SHAW AVE STE 200
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City | FRESNO
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State | CA
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Zip | 93704-2515
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Country | US
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Telephone | 559-221-2613
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Fax | 855-913-2529
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Provider Business Mailing Address
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Address Line | 516 W SHAW AVE STE 200
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City | FRESNO
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State | CA
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Zip | 93704-2515
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Country | US
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Telephone | 559-221-2613
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Fax | 855-913-2529
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Authorized Official
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Title or Position | OWNER/PSYCHOLOGIST
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Name | DR. JACINDA HERNANDEZ
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Credential | PH.D.
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Telephone | 559-242-6693
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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