Active NPI
Joanna Leah Sullivan, PSY.D.
- Clinical Psychologist
- Fresno, CA
National Provider Identifier
1831932516
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY35536
- Practice address
- 4785 N 1St St
Fresno, CA 93726-0500 - Phone
- (559) 448-4620
- NPI assigned
- Jun 18, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY35536 | CA | Primary |
| Clinical Psychologist | 103TC0700X | 13678529-2501 | UT |
Addresses
Primary practice location
4785 N 1St St
Fresno, CA 93726-0500
Mailing address
PO Box 321
Clovis, CA 93613-0321
Phone (651) 728-2415
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY35536 | CA | MD | Clinical Psychologist |
| 13678529-2501 | UT | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sac Health System | Current | Accepting new patients | |
| Sac Health System | Current | Accepting new patients | |
| Sac Health System | Current | Accepting new patients |
Locations
82934 Civic Center Dr
Indio, CA 92201
Phone (760) 477-0733
250 S G St
San Bernardino, CA 92410
Phone (909) 771-2990
1455 3rd Ave
Sn Bernrdno, CA 92408
Phone (909) 382-7146
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Internal Medicine Physician
- Santa Clara, CA
- NPI 1073606299
-
dba SAC Arrowhead
- Federally Qualified Health Center (FQHC)
- San Bernardino, CA
- NPI 1013935923
-
- Federally Qualified Health Center (FQHC)
- San Bernardino, CA
- NPI 1467274126
-
dba Sac Sbusd Resource Center
- Federally Qualified Health Center (FQHC)
- San Bernardino, CA
- NPI 1982164877
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1718668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1779321600000",
"number": "1831932516",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 321",
"city": "CLOVIS",
"state": "CA",
"postal_code": "936130321",
"telephone_number": "651-728-2415"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4785 N 1ST ST",
"city": "FRESNO",
"state": "CA",
"postal_code": "937260500",
"telephone_number": "559-448-4620"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "JOANNA",
"middle_name": "LEAH",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-06-18",
"last_updated": "2026-05-21",
"certification_date": "2026-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY35536",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "UT",
"license": "13678529-2501",
"primary": false
}
],
"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 May 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.