| Vitalize A Professional Psychology Corporation | |
|
155 E Shaw Ave Ste 201 Fresno CA 93710-7619 | |
| (559) 492-1560 | |
| (559) 234-0641 |
| Full Name | Vitalize A Professional Psychology Corporation |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 155 E Shaw Ave Ste 201, Fresno, California |
| Authorized Official Name and Position | Jonathon Baird (CEO) |
| Authorized Official Contact | 5597970116 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vitalize A Professional Psychology Corporation 155 E Shaw Ave Ste 201 Fresno CA 93710-7619 Ph: (559) 492-1560 | Vitalize A Professional Psychology Corporation 155 E Shaw Ave Ste 201 Fresno CA 93710-7619 Ph: (559) 492-1560 |
| NPI Number | 1215769104 |
|---|---|
| Provider Enumeration Date | 08/19/2024 |
| Last Update Date | 08/19/2024 |
| Certification Date | 08/19/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215769104 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| 324500000X | Substance Abuse Rehabilitation Facility | (* (Not Available)) | Secondary |
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