Organization
VITALIZE A PROFESSIONAL PSYCHOLOGY CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHON BAIRD PSYD (CEO)
(559) 797-0116
Entity
Organization
Contact information
Practice address
155 E SHAW AVE STE 201, FRESNO, CA 93710-7619
(559) 492-1560
(559) 234-0641
Mailing address
155 E SHAW AVE STE 201, FRESNO, CA 93710-7619
(559) 492-1560
(559) 234-0641
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
08/19/2024
Last updated
08/19/2024
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