Provider Demographics
NPI:1881556967
Name:PSYCHED TO GROW PSYCHOLOGICAL SERVICES
Entity type:Organization
Organization Name:PSYCHED TO GROW PSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JASMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LOZA
Authorized Official - Suffix:
Authorized Official - Credentials:LEP
Authorized Official - Phone:209-356-5878
Mailing Address - Street 1:3600 SISK RD STE 5A
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95356-0540
Mailing Address - Country:US
Mailing Address - Phone:209-202-3540
Mailing Address - Fax:
Practice Address - Street 1:3600 SISK RD STE 5A
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95356-0540
Practice Address - Country:US
Practice Address - Phone:209-202-3450
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LOZA PSYCHOLOGICAL SERVICES PROF CORP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-11-26
Last Update Date:2025-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty