Provider Demographics
NPI:1528856036
Name:SUMMIT MENTAL WELLNESS: A PSYCHOLOGICAL CORPORATION
Entity type:Organization
Organization Name:SUMMIT MENTAL WELLNESS: A PSYCHOLOGICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JACINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:559-221-2613
Mailing Address - Street 1:516 W SHAW AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93704-2515
Mailing Address - Country:US
Mailing Address - Phone:559-221-2613
Mailing Address - Fax:855-913-2529
Practice Address - Street 1:516 W SHAW AVE STE 200
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93704-2515
Practice Address - Country:US
Practice Address - Phone:559-221-2613
Practice Address - Fax:855-913-2529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-26
Last Update Date:2025-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty