Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jennifer L Mitolo, PSYD

Individual provider Clinical Psychologist · NPI 1861664088

Jennifer L Mitolo, PSYD is a Clinical Psychologist in Irvine, California. Qualified in 2005, 21 years ago. Accepts Medicare assignment and offers telehealth. Licensed in California and New Jersey.

Years since qualifying
21
Licensed in
CA, NJ
In the registry since
2008
Specialties on file
2
What do these letters mean?
PSYD — Doctor of Psychology
A doctoral psychologist trained primarily for clinical practice.

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Practice location Address checks out

4040 Barranca Pkwy Ste 260
Irvine, CA 92604-4780
Phone: (925) 282-1778
Fax: (415) 296-5299
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence PSY25678 (CA)
Clinical Psychologist Taxonomy 103TC0700X · Licence 35SI00448400 (NJ)

Record details

NPI number1861664088
Entity typeIndividual (Type 1)
GenderFemale
Credentials PSYD
Sole proprietorNo
NPI enumeratedMarch 27, 2008
Last updated in NPPESSeptember 16, 2024
Certification dateSeptember 16, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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