Provider Demographics
NPI:1356826515
Name:INTRINSICALLY HEALTHY PSYCHOLOGICAL SERVICES INC
Entity Type:Organization
Organization Name:INTRINSICALLY HEALTHY PSYCHOLOGICAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:SOARES
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:209-988-0801
Mailing Address - Street 1:2084 E RUSH AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93730-4700
Mailing Address - Country:US
Mailing Address - Phone:209-988-0801
Mailing Address - Fax:
Practice Address - Street 1:2575 E PERRIN AVE STE 110
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-5204
Practice Address - Country:US
Practice Address - Phone:209-988-0801
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-03
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health