Fresno Mental Psychological Health Services, P.C.

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

FRESNO MENTAL PSYCHOLOGICAL HEALTH SERVICES, P.C.

Practice address

4021 N Fresno Street, Ste. 101
Fresno, CA 93726

Phone

(559) 307-9505

NPI assigned

Jul 28, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Charmaine Radellant, PSY.D.NPI 1619194347

Title

Psychologist

Phone

(559) 307-9505

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Charmaine Radellant

  • Clinical Psychologist
  • Fresno, CA
  • NPI 1619194347

  CA

  Medicare reassignment Authorized official
• Anthony Lopez-Cortez

  • Mental Health Counselor
  • Fresno, CA
  • NPI 1477374205
  NPD (past)
• Xochitl Sanchez

  • Mental Health Counselor
  • Fresno, CA
  • NPI 1619799707
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1501200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1356865679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4021 N FRESNO ST STE 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937264030",
            "telephone_number": "559-307-9505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4021 N FRESNO STREET, STE. 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93726",
            "telephone_number": "559-307-9505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRESNO MENTAL PSYCHOLOGICAL HEALTH SERVICES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-28",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "RADELLANT",
        "authorized_official_first_name": "CHARMAINE",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "559-307-9505",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fresno Kings Madera Regional Health Authority
• Fresno Long Term Care Medical Group Inc.
• Fresno Medical Center Inc
• Fresno Medical Supply, Inc.
• Fresno Medical Transportation, LLC
• Fresno Metropolitan Ministry
• Fresno Modern Dentistry, Inc
• Fresno Multi-Specialty Clinic
• Fresno Neurosurgical Medical Group, Inc
• Fresno New Connection, Inc.

• All providers in Fresno, CA
• Mental Health Clinic/Center (Including Community Mental Health Center) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.