MIND HARBOR PSYCHOLOGICAL SERVICES INC
NPI 1811790363
Psychologist in San Jose, CA

Active since March 31, 2025
2570 N 1ST ST STE 200, SAN JOSE, CA 95131(650) 613-9897(650) 391-0569 Get Directions Write a Review

NPPES record last updated: September 4, 2026. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Sep 4, 2026, Mar 31, 2025 (2 updates tracked since 2025).

About Mind Harbor Psychological Services Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MIND HARBOR PSYCHOLOGICAL SERVICES INC (NPI 1811790363), doing business as Mind Harbor, is a healthcare organization registered as a psychologist in San Jose, California and active in the NPI registry since March 2025. The organization lists Jet Hermes, Owner, as its authorized official.

NPPES Registry Identity

NPI1811790363
Entity TypeOrganization
Primary Taxonomy103T00000X
Legal Business NameMIND HARBOR PSYCHOLOGICAL SERVICES INC
Location Address2570 N 1ST ST STE 200San Jose, CA 95131-1037
Mailing Address2570 N 1st St Ste 200San Jose, CA 95131-1037 · (650) 613-9897 · Fax (650) 391-0569
Fax(650) 391-0569
Organization SubpartNo
Authorized OfficialJet HermesOwner · (650) 613-9897
Enumeration DateMarch 31, 2025
Last NPPES UpdateSeptember 4, 20262 updates tracked since enumeration
NPPES CertifiedSeptember 3, 2026
✔ NPI 1811790363 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
Also ListedMarriage & Family TherapistTaxonomy 106H00000X
2570 N 1ST ST STE 200, San Jose, CA 95131

Other Names 1

Doing Business AsMind Harbor

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mind Harbor Psychological Services Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Mind Harbor Psychological Services Inc, which bills Medicare for the services this clinician delivers.

Clinician (1)

Clinical Psychologist
NPI 1568018075
2570 N 1ST STREET 2ND FLOOR 1055
San Jose, CA 95131
(650) 613-9897
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mind Harbor Psychological Services Inc's NPI number?

The NPI number for Mind Harbor Psychological Services Inc is 1811790363. It was assigned to this organization in the NPPES registry on March 31, 2025. The provider is doing business as Mind Harbor.

Where is Mind Harbor Psychological Services Inc located?

Mind Harbor Psychological Services Inc is located at 2570 N 1st St Ste 200, San Jose, CA 95131. The listed phone number is (650) 613-9897.

What is Mind Harbor Psychological Services Inc's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Mind Harbor Psychological Services Inc enrolled in Medicare?

Yes. Mind Harbor Psychological Services Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Mind Harbor Psychological Services Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Psychologist) reassigns their Medicare billing to Mind Harbor Psychological Services Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Mind Harbor Psychological Services Inc was last updated on September 4, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.