Organization Active NPI

Summit Mental Wellness: a Psychological Corporation

  • Psychologist
  • Fresno, CA
National Provider Identifier
1528856036
Registry record updated Aug 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
SUMMIT MENTAL WELLNESS: A PSYCHOLOGICAL CORPORATION
Practice address
516 W Shaw Ave Ste 200
Fresno, CA 93704-2515
Phone
(559) 221-2613
Fax
(855) 913-2529
NPI assigned
Apr 26, 2025
Last updated
Aug 6, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2025

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

Authorized official

Name
Dr. Jacinda Hernandez, PH.D.NPI 1083143648
Title
Owner/Psychologist
Phone
(559) 242-6693

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

516 W Shaw Ave Ste 200
Fresno, CA 93704-2515

Mailing address

516 W Shaw Ave Ste 200
Fresno, CA 93704-2515
Phone (559) 221-2613

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250616002067 CA Part B Supplier - Clinic/Group Practice 9931610086 Receives reassigned benefits from 1 practitioner
Practice locations: Fresno, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1745625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754438400000",
    "number": "1528856036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 W SHAW AVE STE 200",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937042515",
            "telephone_number": "559-221-2613",
            "fax_number": "855-913-2529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 W SHAW AVE STE 200",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937042515",
            "telephone_number": "559-221-2613",
            "fax_number": "855-913-2529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT MENTAL WELLNESS: A PSYCHOLOGICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-26",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-06",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "JACINDA",
        "authorized_official_title_or_position": "OWNER/PSYCHOLOGIST",
        "authorized_official_telephone_number": "559-242-6693",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2025; 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.